title: Does catatonic schizophrenia improve faster with electroconvulsive therapy than other subtypes of schizophrenia?
abstract: OBJECTIVE
  Electroconvulsive therapy (ECT) is generally recommended for treating catatonic schizophrenia. Non-catatonic schizophrenia patients also receive ECT. We compared the speed of response to ECT among patients with catatonic and other subtypes of schizophrenia.
  
  
  METHODS
  Consecutive schizophrenia patients referred for ECT within 3 months of starting antipsychotic treatment were studied (19 with catatonic and 34 with non-catatonic schizophrenia). Nurse's Observation Scale for Inpatient Evaluation (NOSIE-30) and Clinical Global Impression (CGI) were used to rate improvement. Referring psychiatrists stopped ECTs based on clinical impression of improvement. Total number of ECTs was taken as an indirect measure of speed of response. NOSIE-30 scores were compared using repeated measures analysis of variance.
  
  
  RESULTS
  Catatonic schizophrenia patients required significantly fewer ECTs to achieve clinically significant improvement. There was a significant group x occasion effect in NOSIE scores, suggesting faster response to ECT in the catatonia group (F=41.6; P<0.001). Survival analysis suggested that patients with catatonic schizophrenia required significantly fewer ECTs (one less session on an average) to achieve clinical improvement (Log-rank statistic =5.31; P=0.02).
  
  
  CONCLUSIONS
  Catatonic schizophrenia responds faster to ECT than non-catatonic schizophrenia. However, the magnitude of the difference is modest.
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India. jagatth@yahoo.com
authors.forename: Jagadisha
authors.initials: J
authors.lastname: Thirthalli
authors.forename: Vivek H
authors.initials: VH
authors.lastname: Phutane
authors.forename: Kesavan
authors.initials: K
authors.lastname: Muralidharan
authors.forename: Channaveerachari Naveen
authors.initials: CN
authors.lastname: Kumar
authors.forename: Bharat
authors.initials: B
authors.lastname: Munishwar
authors.forename: Prashant
authors.initials: P
authors.lastname: Baspure
authors.forename: Bangalore N
authors.initials: BN
authors.lastname: Gangadhar
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000503:physiopathology; D010054:Brief Psychiatric Rating Scale; D004565:Electroconvulsive Therapy / Q000379:methods*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D012559:Schizophrenia / Q000145:classification / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D012560:Schizophrenia, Catatonic / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D012640:Seizures / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D012720:Severity of Illness Index; D055815:Young Adult