Abstract：
Electroconvulsive therapy (ECT) is a safe and effective treatment for major depressive disorder (MDD). After receiving ECT for MDD there is a large risk of relapse within the first year. Patient attitudes towards renewed treatment could impact their decisions regarding future therapy. We conducted a nationwide cohort study, using data from Swedish registers. Patients with MDD who received ECT were followed up to six months after the initial ECT-series. We investigated if certain patient and treatment characteristics during the initial treatment were correlated to their attitude towards renewed ECT at the six-month follow-up. Logistic regression models were used to calculate adjusted odds ratios for predictors. The Bonferroni method was used to adjust significance levels for multiple testing. The study included 1917 patients. 51.1% of patients were positive, 27.6% were undecided and 21.3% were negative towards renewed treatment. Patients with response to treatment were less likely to have a negative attitude towards renewed ECT (odds ratio 0.32, 95% CI 0.25-0.41, P < 0.001). Moreover, patients with experience of ECT prior to the index series were less likely to have a negative attitude towards renewed ECT (odds ratio 0.44, 95% CI 0.34-0.58, P < 0.001). In order to minimize the risk of negative attitudes towards renewed ECT for MDD, treatment should primarily be reserved for patients that are likely to respond to ECT.
摘要：
电惊厥治疗（ECT）是治疗重度抑郁症（MDD）的一种安全有效的方法。在接受ECT治疗MDD后，第一年内复发的风险很大。患者对重新治疗的态度可能会影响他们对未来治疗的决定。我们进行了一项全国性的队列研究，使用瑞典登记处的数据。接受ECT治疗的MDD患者在初次ECT系列治疗后随访6个月。我们调查了初始治疗期间的某些患者和治疗特征是否与他们在六个月的随访中对更新的ECT的态度相关。使用Logistic回归模型计算预测因子的调整后比值比。Bonferroni方法用于调整多重测试的显著性水平。该研究包括1917名患者。51.1%的患者为阳性,27.6％的患者不确定，21.3％的患者对重新治疗呈阴性。对治疗有反应的患者不太可能对更新的ECT持消极态度（比值比0.32，95％CI0.25-0.41，P<0.001）。此外，在指数系列之前有ECT经历的患者对更新的ECT持否定态度的可能性较小(比值比0.44,95%CI0.34-0.58,P<0.001).为了最大程度地减少对MDD的新ECT持消极态度的风险，治疗应主要针对可能对ECT有反应的患者.
