Remission in schizophrenia after a course of electroconvulsive therapy and pharmacotherapy: a prospective comparative study

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Schizophrenia is a disabling mental illness and one of the world’s top 10 causes of long-term disability. Currently, the application of electroconvulsive therapy (ECT) for schizophrenia is controversial. Although a combination of ECT with antipsychotics has been reported to have superior outcomes compared with other strategies, the results have been inconsistent. We investigated the short-term outcomes of ECT in a group of Egyptian patients diagnosed with schizophrenia.

Patients and methods

This study was a prospective comparative study that included 73 patients of both sexes diagnosed with schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., criteria. Patients were recruited from the inpatient department of the Institute of Psychiatry, Ain Shams University, in the period from January 2013 to June 2013. The first group received antipsychotics and ECT, whereas the second group received same antipsychotics alone. Assessment of severity was established before and after the course of ECT using the Positive and Negative Syndrome Scale psychometric scales and the remission criteria of Nancy Andreasen. In addition, data on previous history of ECT were collected to evaluate the effect of previous ECT on outcome.


There were no significant differences in most of the studied outcome parameters between both groups, except for reduction of the negative symptoms scale (P=0.049) and the total score of Positive and Negative Syndrome Scale (P=0.023), which were higher in patients who did not receive ECT. Furthermore, patients with schizophrenia who had previously received ECT showed longer duration of illness; however, 63.3% of these patients received an episodic course of ECT versus 61.3% of those who had not received previous ECT had received a continuous course.


In this study, combining ECT with drugs had no effect on remission. However, it is too early to state that ECT plays no role in the treatment of schizophrenia; more multicenter studies may be needed that overcome the bias in this study to deny or prove this effect.

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