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Abstract
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AIM: To retrospectively explore the clinical treatment situation of the elderly with depression in hospitalization.
METHODS: One hundred and thirty-one elderly inpatients with depression in the Shanghai Mental Health Center were selected. Their clinical records were collected from the medical record library to fill the related data into the designed questionnaires for retrospective analysis of the main symptoms, bady state and treatment state. Hamilton depression scale (HAMD) was used for comparison of the effect of the patients with different antidepressants before and after treatment. The scale used 0-4 score, 5 grades rating: 0 score meant no symptom of this item, 4 score as very serious degree. The incidence rats of adverse effect between patients treated with selective serotonin reuptake inhibitors (SSRIs) and cyclic antidepressants (TCA) were compared with the adverse effect scale (0-4 score rating: 0 score meant no symptom of this item, 4 score as very serious) after treatment, and the results of blood analysis, liver function, electrocardiogram before and after treatment. Self-designed brief psychiatric symptoms inventory for elderly patients was used to compare the psychiatric symptom of the patients after modified electroconvulsive therapy (MECT) or without MECT.
RESULTS: All the 131 elderly inpatients entered the result analysis. 1 Comparison of antidepressants efficacy: Both SSRIs and TCA had good effect on elderly patients with depression and their changes of HAMD scores before and after treatment were similar. 2Comparison of antidepressants side effects: SSRIs had fewer side effects than the TCA, and there were significant differences in the incidence number except sweating, losing appetite, nausea, vomiting and insomnia. 3Comparison of psychiatric symptoms of the patients with or without MECT: In 131 cases, 71 ones used the MECT (54.2%) and 60 ones not MECT (45.8%), patients with MECT had higher prevalence of suicide attempt and suicide behaviors than that without MECT (50.0%, 18.3%, P < 0.05).
CONCLUSION: The findings suggest that SSRIs and TCA have the same effect, but the adverse effects of the former are significantly fewer and lighter than the latter. The first use for the patients with suicide attempt or suicide behavior is MECT.
Language: zh |