Electroconvulsive therapy found to reduce severity of certain mental illnesses

Researchers have found that electroconvulsive therapy (ECT), where an electric current is passed through the brain, can reduce the severity of mental illnesses. The findings were presented at EPA 2024.

ECT is a safe and effective treatment for some mental illnesses including severe/psychotic depression, postnatal psychosis and mania. Patients are placed under general anesthetic and the brain is stimulated with short electric pulses. This causes a brief seizure which lasts for less than two minutes.

The use of ECT across Scotland was assessed over an 11-year period from 2009 to 2019 using data from the Scottish Electroconvulsive Therapy (ECT) Audit Network (SEAN). The Scotland-wide naturalistic study assessed the efficacy and side effects of ECT across a range of common mental illnesses such as depression, bipolar depression, schizophrenia, and mania.

Key findings from the study include:

• ECT was shown to be effective in reducing illness severity, as measured by Clinical Global Impression Scale (CGI-S). CGI-S is a validated clinician administered assessment tool which measures illness severity.
• 2,920 ECT episodes had CGI-S scores recorded for patients before and after treatment. The mean CGI-S score prior to treatment indicated marked illness severity (5.03 95% CI 4.99–5.07), while after treatment, the mean CGI-S score was reduced to 2.07, (95% CI 2.03–2.11) indicating a reduction to borderline illness severity.
• The study also assessed side effects of ECT. Anesthetic complications and prolonged seizures were rare, occurring in <1% of treatment episodes. Cardiovascular complications were reported in 2.2%. Nausea was reported in 7.2% and muscle aches in 12%. Confusion was reported in 19% and cognitive side effects in 26.2%.

Dr. Julie Langan Martin, Senior Clinical Lecturer in Psychiatry, Director of Education at the University of Glasgow, Scotland, said "Our findings from this large naturalistic study across Scotland from over an 11-year period reinforce the widely held, but nonetheless underexplored view, that ECT is both a safe and effective treatment when delivered to appropriate groups of people with severe mental illness. Monitoring of side effects, especially cognitive side effects should be undertaken carefully and rigorously in all patients receiving ECT."

"This study on ECT presents compelling evidence of its effectiveness in reducing the severity of mental illnesses, with major side effects found to be rare. It challenges common misconceptions and stigmas associated with ECT, providing valuable insights that can reshape public perceptions and stimulate informed discussions among health care professionals," said Dr. Julian Beezhold, Secretary General of the European Psychiatric Association.