정신분열증 환자의 전기충격치료후 증상 변화와 혈장 Prolaction，ACTH , Cortisol치 변화에 관한 연구

Changes of Plasma Prolactin, ACTH and Cortisol and Clinical Symptoms After ECT in the Schizophrenic Patients

The purpose of this study was to observe the changes in the levels of PRL, ACTH and cortisol and clinical symptoms after ECT of schizophrenic patients and to find out the correlations between the effect o f ECT on hypothalamic-pituitary axis and clinical symptoms. The subjects were 15 inpatients who met DSM-III-R diagnonsitic criteria for schizophrenia and ECT was applied to them 8 times. Venous blood was sampled 15 minutes before (preECT) and after(postECT) the 1st and 8th ECT. Plasma levels of PRL, A CTH and cortisol were measured by RIA . C linical symptoms were assessed before 1st ECT and after the 8th ECT by BPRS. The results are as follows 1) After the 8th ECT, BPRS scores, especially thinking disturbance and withdrawl/retardation were significantly decreased as compared to those before the 1st ECT (p<0.01). 2) Plamsa levels of postECT PRL, ACTH and cortisol were significantly higher than preECT levels of the 1st and 8th ECT. 3) Plasma levels of preECT P R L at 8th ECT were significantly lower than the baseline levels(p<0.05) and response rate of PRL(postECT-preECT) was significantly decreased on the 8th ECT as compared to the 1st ECT (p<0.05). In conclusion, the changes in the levels of PRL, ACTH and cortisol after ECT were caused by the changes of activity of central neurotransmitters, result in the improvement of schizophrenic symptoms. In particular, repeated ECT were related to an increase in the activity of dopam inergic receptor, which can explain the effect of ECT on the improvement of negative symptoms in chronic schizophrenia.