Electroconvulsive Therapy in Refractory Obsessive-Compulsive Disorder

Abstract

Electroconvulsive therapy (ECT) is a treatment of undisputed efficacy for severe and treatment-resistant psychiatric disorders. Notwithstanding extensive data on efficacy and safety, it is significantly underused, corresponding to one of the most stigmatized approaches in psychiatry. The list of problems for which ECT is potentially effective does not include obsessive-compulsive disorder (OCD), resulting in only a few available case reports in the literature in which OCD is the target of this specific therapeutic strategy. The authors describe a patient with refractory OCD for whom ECT was prescribed, with remarkable clinical response and functional improvement. The existence of a clear response to ECT in reported cases of OCD, albeit in a globally small number of patients, should make it essential to identify predictors of ECT response that could assist clinicians in assessing and guiding such cases, particularly those labeled as refractory to treatment.

The Therapeutic Effect of Electroconvulsive Therapy in Patients With Obsessive-compulsive Disorder: A Quasi-experimental Study

“…In our study, ECT was effective in the treatment of OCD without comorbid psychiatric disorders in both short-and mid-term evaluations. Some studies reported the data of patients with OCD who responded positively to ECT (Bülbül et al, 2013;Martins-Correia et al, 2021;Raveendranathan et al, 2012). Khanna et al reported the short-term anti-obsessional ECT outcomes in nine OCD cases (Khanna et al, 1988).…”

“…Also, Bülbül et.al concluded ECT for patients with a depressive episode of bipolar disorder and concurrent OCD and reported that both depression and OCD symptoms were successfully treated with ECT (Bülbül et al, 2013). In a study executed by Martins-Correia et.al, ECT was administered for a patient with refractory OCD, and the patient's clinical response and functional improvement were significant (Martins-Correia et al, 2021). Some other case reports also have demonstrated the positive effect of ECT on severe OCD patients (Hanisch et al, 2009;Loi & Bonwick, 2010;Tomruk et al, 2010) Because of the fear of neurological side effects, ECT for treatment of OCD was for decades a controversial treatment for treating OCD, but the patient's acceptance of this treatment has recently increased because the studies support the idea that the benefits of ECT outweigh the disadvantages (Moksnes et al, 2006).…”

“…They reported that both depression and OCD symptoms were successfully treated with ECT. In a study executed by Martins-Correia et al (2021) , ECT was administered to a patient with refractory OCD, and the patient's clinical response and functional improvement were significant. Some other case reports also have demonstrated the positive effect of ECT on severe OCD patients ( Hanisch et al, 2009 ; Loi & Bonwick, 2010 ; Tomruk et al, 2010 ).…”

Electroconvulsive therapy for obsessive-compulsive disorder: A retrospective study

“…Due to this, ECT has a certain effect on OCD patients, but it has a less significant effect on refractory patients. The use of ECT has also been associated with significant improvements in refractory OCD in many cases (24)(25)(26)(27)(28)(29)(30)(31).…”

“…Due to this, ECT has a certain effect on OCD patients, but it has a less significant effect on refractory patients. The use of ECT has also been associated with significant improvements in refractory OCD in many cases ( 24 – 31 ). A small prospective study also found that ECT had an anti-obsessional effect ( 32 ).…”