Skip to main content
SpringerLink
Log in

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

  • Original Paper
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cerletti UBL (1938) Lélettroshock. archivio generale di neurologia, psichiatria e psicoanalisi 19:266–268

  2. van Waarde JA, Verwey B, van der Mast RC (2009) Meta-analysis of initial seizure thresholds in electroconvulsive therapy. Eur Arch Psychiatry Clin Neurosci 259:467–474

    Article  PubMed  Google Scholar 

  3. Van PT, Marder SR, Mintz J (1990) A controlled dose comparison of haloperidol in newly admitted schizophrenic patients. Arch Gen Psychiatry 47:754–758

    Google Scholar 

  4. Kane JM, Honigfeld G, Singer J, Meltzer H (1988) Clozapine in treatment-resistant schizophrenics. Psychopharmacol Bull 24:62–67

    PubMed  CAS  Google Scholar 

  5. Kho KH, Blansjaar BA, de VS, Babuskova D, Zwinderman AH, Linszen DH (2004) Electroconvulsive therapy for the treatment of clozapine nonresponders suffering from schizophrenia–an open label study. Eur Arch Psychiatry Clin Neurosci 254:372–379

    Article  PubMed  CAS  Google Scholar 

  6. MSCESK Caroff SN (2004) Epidemiology. In: In Caroff SN, Ge MSFAF (eds) Catatonia: from psychopathology to neurobiology. American Psychiatric Press, Washington, DC

    Google Scholar 

  7. Chanpattana W, Chakrabhand ML (2001) Combined ECT and neuroleptic therapy in treatment-refractory schizophrenia: prediction of outcome. Psychiatry Res 105:107–115

    Article  PubMed  CAS  Google Scholar 

  8. Chanpattana W, Andrade C (2006) ECT for treatment-resistant schizophrenia: a response from the far East to the UK. NICE report. J ECT 22:4–12

    Article  PubMed  Google Scholar 

  9. Painuly N, Chakrabarti S (2006) Combined use of electroconvulsive therapy and antipsychotics in schizophrenia: the Indian evidence. A review and a meta-analysis. J ECT 22:59–66

    Article  PubMed  Google Scholar 

  10. Tharyan P, Adams CE (2005) Electroconvulsive therapy for schizophrenia. Cochrane Database Syst RevCD000076

  11. American Psychiatric Association (2001) The practice of ECT: recommendation for the treatment, training, and privileging (A Task Force Report of the American Psychiatric Association). American Psychiatric Press, Washington

    Google Scholar 

  12. Andersson JE, Bolwig TG JHA SK. [ECT behandling I Danmark.]. 1-102. 2002. Copenhagen, Danish psychiatric society

  13. National Institute for Clinical Excellence. Guidance on the Use of Electroconvulsive Therapy (2003) London, National Institute for Clinical Excellence (NICE). Technology Appraisal 59

  14. Munk-Jorgensen P, Kastrup M, Mortensen PB (1993) The Danish psychiatric register as a tool in epidemiology. Acta Psychiatr Scand Suppl 370:27–32

    Article  PubMed  CAS  Google Scholar 

  15. Nothdurfter C, Eser D, Schule C, Zwanzger P, Marcuse A, Noack I, Moller HJ, Rupprecht R, Baghai TC (2006) The influence of concomitant neuroleptic medication on safety, tolerability and clinical effectiveness of electroconvulsive therapy. World J Biol Psychiatry 7:162–170

    Article  PubMed  Google Scholar 

  16. Guy W (2008) Clinical global impressions scale. In: Rush JABD (ed) Handbook of psychiatric measures. American Psychiatric publishing, Washington, DC, pp 90–92

    Google Scholar 

  17. Bauer J, Hageman I, Dam H, Baez A, Bolwig T, Roed J, Olsen NV, Jorgensen MB (2009) Comparison of propofol and thiopental as anesthetic agents for electroconvulsive therapy: a randomized, blinded comparison of seizure duration, stimulus charge, clinical effect, and cognitive side effects. J ECT 25:85–90

    Article  PubMed  CAS  Google Scholar 

  18. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders: DSM-IV. American Psychiatric Press, Washington, DC

    Google Scholar 

  19. Braga RJ, Petrides G (2005) The combined use of electroconvulsive therapy and antipsychotics in patients with schizophrenia. J ECT 21:75–83

    Article  PubMed  CAS  Google Scholar 

  20. Tang WK, Ungvari GS (2003) Efficacy of electroconvulsive therapy in treatment-resistant schizophrenia: a prospective open trial. Prog Neuropsychopharmacol Biol Psychiatry 27:373–379

    Article  PubMed  Google Scholar 

  21. Ucok A, Cakr S (2006) Electroconvulsive therapy in first-episode schizophrenia. J ECT 22:38–42

    Article  PubMed  Google Scholar 

  22. Chanpattana W, Sackeim HA (2010) Electroconvulsive therapy in treatment-resistant schizophrenia: prediction of response and the nature of symptomatic improvement. J ECT 26(4):289–298

    Article  PubMed  Google Scholar 

  23. Damm J, Eser D, Schule C, Obermeier M, Moeller HJ, Rupprecht R, Baghai TC (2010) Influence of age on effectiveness and tolerability of electroconvulsive therapy. J ECT 26(4):282–288

    Article  PubMed  Google Scholar 

  24. The UK ECT Review Group (2003) Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet 361:799–808

    Article  Google Scholar 

  25. Dodwell D, Goldberg D (1989) A study of factors associated with response to electroconvulsive therapy in patients with schizophrenic symptoms. Br J Psychiatry 154:635–639

    Article  PubMed  CAS  Google Scholar 

  26. Miller CE, Sharif ZA (1998) Efficacy of ECT in chronic aggressive behavior in schizophrenic/schizoaffective disorder inpatients. Schizophr Res 29:163

    Article  Google Scholar 

  27. Stromgren LS (1997) ECT in acute delirium and related clinical states. Convuls Ther 13:10–17

    PubMed  CAS  Google Scholar 

  28. Fink M, Taylor MA (2001) The many varieties of catatonia. Eur Arch Psychiatry Clin Neurosci 251(1):I8–I13

    Article  PubMed  Google Scholar 

  29. Chanpattana W, Kramer BA (2003) Acute and maintenance ECT with flupenthixol in refractory schizophrenia: sustained improvements in psychopathology, quality of life, and social outcomes. Schizophr Res 63:189–193

    Article  PubMed  Google Scholar 

  30. Shimizu E, Imai M, Fujisaki M, Shinoda N, Handa S, Watanabe H, Nakazato M, Hashimoto K, Iyo M (2007) Maintenance electroconvulsive therapy (ECT) for treatment-resistant disorganized schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 31:571–573

    Article  PubMed  Google Scholar 

  31. Suzuki K, Awata S, Takano T, Ebina Y, Iwasaki H, Matsuoka H (2005) Continuation electroconvulsive therapy for relapse prevention in middle-aged and elderly patients with intractable catatonic schizophrenia. Psychiatry Clin Neurosci 59:481–489

    Article  PubMed  Google Scholar 

  32. Swoboda E, Conca A, Konig P, Waanders R, Hansen M (2001) Maintenance electroconvulsive therapy in affective and schizoaffective disorder. Neuropsychobiology 43:23–28

    Article  PubMed  CAS  Google Scholar 

  33. Levy-Rueff M, Jurgens A, Loo H, Olie JP, Amado I (2008) Maintenance electroconvulsive therapy and treatment of refractory schizophrenia. Encephale 34:526–533

    Article  PubMed  CAS  Google Scholar 

  34. Wustmann T, Pillmann F, Marneros A (2010) Gender-related features of persistent delusional disorders. Eur Arch Psychiatry Clin Neurosci [Epub ahead of print]

Download references

Acknowledgments

Thanks to Linda Lund Schou and Helen G Nielsen for valuable secretary assistance.

Conflicts of interest

The authors report no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Psychiatry, Glostrup University Hospital, Copenhagen, Denmark

    Diana Kristensen

  2. Department of Psychiatry, Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark

    Jeanett Bauer, Ida Hageman & Martin Balslev Jørgensen

  3. Psychiatric Centre Sankt Hans, Department M, Building 12, Boserupvej 2, 4000, Roskilde, Denmark

    Diana Kristensen

Authors
  1. Diana Kristensen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jeanett Bauer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ida Hageman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Martin Balslev Jørgensen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Diana Kristensen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kristensen, D., Bauer, J., Hageman, I. et al. Electroconvulsive therapy for treating schizophrenia: a chart review of patients from two catchment areas. Eur Arch Psychiatry Clin Neurosci 261, 425–432 (2011). https://doi.org/10.1007/s00406-010-0173-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00406-010-0173-3

Keywords

Search

Navigation