精神分裂病에 서 電氣衝擊 및 藥物併用療法과 藥物單獨療法의 比較 硏究

A Comparative Study between ECT with Pharmacotherapy and Phamacotherapy-Alone in Schizophrenia

In order to evaluate the therapeutic effect of ECT in schizophrenia, the author compared the various clinical aspects of ECT and pharmacotherapy with those of pharmacotherapyalone .in hospitalization and after-discharge. The author selected 46 patients as index group among 53 patients who received ECT with phar macotherapy who were discharged from Jan. 1. ’76 to Dec. 31. ’82 in Seoul National University Hospital and selected 46 patients as a control group matched with a index group accordingto the controlled variables of sex, subtypes of schizophrenia, age, duration of illness and marital status. Comparing the duration of hospitatalization of index admission, maximum drug dosage and drug dosage at discharge, the outcome of treatment and the mode of discharge, the author compared the therapeutic effect in hospitalization of both groups. Also the author compared one year follow-up rate and the recurrence rate within one year after index discharge. The results were as follows: 1) The most common reason for ECT was ineffectiveness of pharmacotherapy (41.3%). followed by first choice of treatment (10.98%) suicidal attempt (10.8%) and refusal of food and drug (10.8%). 2) The average number of ECT administered was 12.8 in the total patients, 9.9 in acute cases and 14.9 in chronic cases. The author also obtained good therapeutic effect in acute cases with less number of ECT administered than in chronic cases. 3) The duration of hospitalization was significantly shorter in the patients who showed therapeutic effect with ECT within 14th hospital day than with pharmacotherapy-alone. 4) ECT reduced necessary maximum drug dosage of antipsychotics for therapeutic effect but had no influence on maintenance dosage. 5) There was no difference in the therapeutic result and the mode of discharge between ECT with pharmacotherapy and pharmacotherapy- alone. 6) There was no significant difference in one year ambulatory treatment through OPD after index discharge between ECT with pharmacotherapy and pharmacotherapy-alone. 7) There was no significant difference in the recurrence rate within one year after index discharge between ECT with pharmacotherapy and pharmacotherapy-alone but the recurrence rate was lower in acute cases treated with ECT and pharmacotherapy than treated with pharmacotherapy-alone.