Effectiveness of Electroconvulsive Therapy and Associated Cognitive Change in Schizophrenia

Tor, Phern‐Chern; Ying, Jiangbo; Ho, New Fei; Wang, Mingyuan; Martin, Donel; Ang, Chai Pin; Tan, C.S.; Yap, Lee Shen; Lu, Vincent John Magat; Simpson, Brian; Mok, Yee Ming; Loo, Colleen

doi:10.1097/yct.0000000000000422

Cited by 31 publications

(17 citation statements)

References 39 publications

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“…reported no significant difference with the Mini‐Mental State Examination. Our results, however, are similar to our recent ECT study, which also found improvement in cognitive outcomes. This improvement in cognitive outcomes can be explained by the possible difference in the method of ECT administration: Kaster et al .…”

Section: Discussionsupporting

confidence: 91%

“…Evidence regarding the effectiveness and cognitive side‐effects of different types of ECT in schizophrenia is scarce. Although a recent Singapore‐based study comparing bifrontal, bitemporal, and right unilateral ECT showed no difference in effectiveness and cognitive outcomes, it was a retrospective study with small sample sizes and significant limitations in methodology. Phutane et al .…”

Section: Methodsmentioning

confidence: 99%

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Clinical effectiveness and speed of response of electroconvulsive therapy in treatment‐resistant schizophrenia

Chan

Abdin

Seow

et al. 2019

Psychiatry Clin Neurosci

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Aim Although electroconvulsive therapy (ECT) has been shown to be efficacious for patients with treatment‐resistant schizophrenia, there has been limited evidence on the rate of response, cognition, and quality‐of‐life outcomes. The primary aims of the present study were thus to examine the effectiveness and speed of response to ECT in a naturalistic retrospective cohort in patients with treatment‐resistant schizophrenia. Methods We performed a retrospective database analysis. The primary effectiveness outcome was defined as an improvement of ≥40% from pretreatment scores based on the Brief Psychiatric Rating Scale (BPRS) Psychotic Symptom subscale. Data were included for analysis for all patients with a primary DSM‐5 diagnosis of schizophrenia that was treatment‐resistant and who had had an acute course of ECT initiated for the treatment of schizophrenia between 1 July 2016 and 1 December 2016. Results A total of 50 inpatients were included for analysis. The present study revealed that 50% of patients showed at least a 40% reduction in BPRS Psychotic Symptom subscale scores after completion of ECT and that 16.7% of patients responded after the first three sessions, 39.3% after six sessions, 46.4% after nine sessions, and 50% after 12 sessions. The greatest improvement in BPRS scores was between the third and sixth ECT sessions. BPRS scores, Clinical Global Impression, Montreal Cognitive Assessment, and Global Assessment of Functioning showed significant improvement. There was no significant difference in quality‐of‐life outcomes. Conclusion Utilizing modern techniques in treatment‐resistant schizophrenia, this study demonstrates the real‐world effectiveness and rate of response of patients receiving ECT.

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Section: Discussionsupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Clinical effectiveness and speed of response of electroconvulsive therapy in treatment‐resistant schizophrenia

Chan

Abdin

Seow

et al. 2019

Psychiatry Clin Neurosci

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“…The authors note that the differences reported were small and perhaps clinically insignificant. In the aforementioned Tor et al [30], the efficacy of 3 different placements was compared. No single placement showed significant superiority.…”

Section: Resultsmentioning

confidence: 99%

“…[30] compared the symptomatic and cognitive outcomes of patients with schizophrenia receiving one of 4 ECT modalities: bitemporal ECT with age-based dosing, right unilateral (RUL) ECT with seizure threshold (ST)-based dosing, bitemporal ECT with ST-based dosing, or bifrontal ECT with ST-based dosing. The Montreal Cognitive Assessment and BPRS were administered to 62 patients before and after a course of ECT.…”

Section: Resultsmentioning

confidence: 99%

Electroconvulsive Therapy and Schizophrenia: A Systematic Review

Ali¹,

Mathur²,

Malhotra³

et al. 2019

Complex Psychiatry

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Electroconvulsive therapy (ECT) is a remarkably effective treatment for major depressive disorder, but is less commonly utilized for treatment of psychotic disorders. Recent literature indicates that ECT can be a useful strategy for a wide range of psychotic disorders, including treatment-resistant schizophrenia. The purpose of this review is to examine the extant literature on ECT in schizophrenia with a primary focus on its efficacy, its impact on cognitive function, the role of maintenance ECT, and the potential role of neuroimaging biomarkers to provide more precise ECT treatment strategies. We evaluated the available literature, with a particular focus on prospective, randomized trials. Our review suggests that ECT can be an effective treatment strategy in this severely ill patient population. Studies suggest that while ECT in schizophrenia is a safe treatment modality, the potential for cognitive impairment must always be carefully weighed. The use and investigation of new biomarker strategies for the pharmacological treatment of schizophrenia, and the extension of these approaches to ECT are also discussed.

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“…5,[14][15][16][17][18] A further 17 studies included at least one patient older than 60 years of age within a mixed-age cohort, or a mixed-diagnoses cohort where outcomes specific to patients with primary psychotic conditions were reported (Table 2). 4,10,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]…”

Section: Resultsmentioning

confidence: 99%

Acute electroconvulsive therapy in the elderly with schizophrenia and schizoaffective disorder: a literature review

Kumagaya

Halliday

2019

Australas Psychiatry

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Objectives: This study reviewed the evidence regarding the efficacy of acute electroconvulsive therapy for primary psychotic conditions in the elderly. Methods: A literature search was performed using the Medline, Embase and Cochrane databases. Results: Acute electroconvulsive therapy resulted in an improvement of psychotic symptoms in almost all elderly patients, a large proportion of whom had treatment-resistant conditions. No electroconvulsive therapy related fatalities or severe medical complications were encountered. Conclusions: Acute electroconvulsive therapy may present a valuable treatment modality for elderly patients with primary psychotic conditions who do not respond adequately to antipsychotic medications.

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Effectiveness of Electroconvulsive Therapy and Associated Cognitive Change in Schizophrenia

Abstract: Our present findings suggest that an acute course of ECT is effective in schizophrenia and may have cognitive benefits for some patients.

Cited by 31 publications

References 39 publications

Clinical effectiveness and speed of response of electroconvulsive therapy in treatment‐resistant schizophrenia

Clinical effectiveness and speed of response of electroconvulsive therapy in treatment‐resistant schizophrenia

Electroconvulsive Therapy and Schizophrenia: A Systematic Review

Acute electroconvulsive therapy in the elderly with schizophrenia and schizoaffective disorder: a literature review

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