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

Abstract

Background: Electroconvulsive therapy (ECT) is demonstrated to be an effective treatment in some psychiatric disorders. It is postulated ECT should primarily be considered for patients with treatment-resistant obsessive-compulsive disorder (OCD) in the context of major depression. Therefore, we aimed to evaluate the efficacy of ECT in OCD patients without comorbid psychiatric disorders. Methods: This quasi-experimental study was conducted on 12 adult patients with severe OCD (Yale-Brown test score above 25) and no comorbid psychiatric disorders referred to a tertiary care hospital for psychiatric disorders. Treatment was administered three times a week for up to three to four weeks (a minimum of 8 sessions and a maximum of 12 sessions). We completed the Yale-Brown test for all the patients exactly before ECT, on the exact day after applying ECT, and two months after the final ECT session in order to evaluate the effect of therapy. Results: Yale-Brown score of patients significantly decreased after the ECT sessions from 28.08 ± 2.50 to 17.17 ± 3.78 (P-value, 0.043). After treatment, the severity of OCD improved in all patients and reduced to mild and moderate levels in 4 (33.3%) and 8 (66.7%) patients, respectively. After two months the mean Yale-Brown score slightly increased to 18.08 ±1.62 (P-value, 0.125) and the severity of OCD in all 12 patients (100%) became moderate. Nevertheless, in none of them, the Yale-Brown score increased up to the baseline value in this period. None of the patients developed significant side effects during/after ECT sessions. Conclusion: ECT was a safe and effective therapeutic strategy for patients with treatment-resistant OCD with no comorbid psychiatric disorders in our study. However, further randomized controlled trials are required to validate the efficacy of ECT for OCD treatment before implementing it into routine clinical practice.