Electroconvulsive therapy for treating schizophrenia: a chart review of patients from two catchment areas

Abstract

To examine disease and treatment characteristics of patients with schizophrenia treated with electroconvulsive therapy (ECT). We examined charts from 79 patients diagnosed with schizophrenia (n = 55), persistent delusional disorders (n = 7), and schizoaffective disorders (n = 17) between 2003 and 2008. We recorded age, sex, indication for ECT, number of ECT sessions, ECT series, outcome, maintenance ECT, use of antipsychotics, duration of illness, and duration of the current exacerbation. All patients were taking antipsychotics at the time of enrolment in the study. Acute ECT included 2-26 sessions; maintenance ECT (M-ECT) was given to 18 patients for up to 12 years. Initial indications for ECT included psychosis (n = 28), pronounced affective symptoms (n = 28), delirious states (n = 20), and M-ECT (n = 3). Most patients experienced excellent/good outcomes (n = 66), but others experienced moderate (n = 8) or poor (n = 5) outcomes. No factors were identified that predicted treatment responses in individual patients. ECT proved to be effective in a population of patients that were severely ill with treatment-refractory schizophrenia. This does not imply that the patients were cured from schizophrenia. Rather, it reflects the degree of relief from psychosis and disruptive behaviour, as described in the patient charts. The treatment was often offered to patients after considerable disease durations.

Electroconvulsive shock attenuated microgliosis and astrogliosis in the hippocampus and ameliorated schizophrenia-like behavior of Gunn rat

“…In a chart review by Kristensen, 18 patients received maintenance ECT in addition to antipsychotics. It was very effective in stabilizing the patients and reducing the length of hospital stay [52]. Another study has shown that continuous or maintenance ECT is safe and effective for chronically hospitalized patients.…”

Electroconvulsive Therapy and Schizophrenia: A Systematic Review

“…Retrospective studies indicate that the use of continuation and maintenance ECT (C-ECT) is effective in terms of reducing the risk of relapse and readmission rates [31, 32]. Unfortunately, few prospective studies regarding maintenance in schizophrenia are available.…”

The Effects of Continuation-Maintenance Electroconvulsive Therapy on Reducing Hospital Re-Admissions in Patients with Treatment-Resistant Schizophrenia

“…More specifically, Kristensen et al 10). evaluated the efficacy of ECT augmentation in 66 TRS patients, and 18 patients also received the maintenance ECT for periods ranging from 3 months to 12 years (mean, 2.2 years).…”

“…The frequency of C/M-ECT is reduced after the index ECT, lengthening the intervals between treatments from weekly to fortnightly, then monthly to prevent relapse (continuation) or recurrence (maintenance) 7,8). Most of previous studies on C/M-ECT for TRS schizophrenia were limited by the nature of the study design9) or the usage of qualitative outcome measures 10). Meanwhile, one study reported the effectiveness of maintenance ECT by retrospective analysis of 19 patients which showed that the mean duration of yearly hospitalization was decreased by 80% in chronic schizophrenia 11).…”