【正文】
ture. Treatment of lifelong insomnia (not associated with depression) with chronic nightly opioid medication has been reported, including a review of the literature on atypical treatments of extreme insomnia. Based upon Medline, PsycInfo, and Embase literature searches, this appears to be the first published case of paradoxical insomnia (formerly called “sleep state misperception”) responsive to ECT. 與原發(fā)性失眠 , 以及單純的矛盾性失眠患者不同 ,那些伴隨抑郁障礙以及以主觀睡眠感覺更加精確為特征使這一病例成為一個獨特的亞型 , 在 24個月的隨訪期間抑郁癥和矛盾性失眠癥完全緩解 。 Unlike patients with primary, and certainly paradoxical insomnia, those with depressive disorders are typically more accurate in their subjective perceptions of sleep, making this case a unique subtype for whom plete remissions of major depression and paradoxical insomnia were maintained at a 24month followup visit. 在進行電休克治療之前 , 患者的失眠是無藥可治的 ,包括喹硫平 , 治療使她的睡眠主觀錯覺正常化 。 即使沒有睡眠日記信息 ,在電休克療法治療前后 , 她的個人報告都是明顯不同的 。 Before ECT, her insomnia plaint had been refractory to pharmacotherapy, including quetiapine, and this subjective misperception of sleep normalized with the treatment. Even without sleep diary information, her consistent selfreports before and after ECT were clearly different. 電休克治療是公認的安全 、 有效 ,且耐受良好的治療抑郁癥的治療方法 。 失眠通常在抑郁癥之前出現(xiàn) 。本病例建立了矛盾性失眠也可以預(yù)示嚴重自殺傾向的抑郁癥 ,并記錄了電休克治療對兩種疾病共同癥狀的療效 。 ECT is well established as safe, effective, and generally welltolerated treatment for major depression. Insomnia monly precedes major depression. This case establishes that paradoxical insomnia can also herald major depression of suicidal severity, and documents the impact of ECT on the symptoms mon to both. (完)