Do ictal EEG characteristics predict treatment outcomes in schizophrenic patients undergoing electroconvulsive therapy?
OBJECTIVE
The aim of this study is to investigate the relationship between features of electroencephalography (EEG), including seizure time, energy threshold level and post-ictal suppression time, and clinical variables, including treatment outcomes and side-effects, among schizophrenia inpatients undergoing electroconvulsive therapy (ECT).


METHODS
This is a naturalistic follow-up study on schizophrenia patients, diagnosed using DSM-IV-TR criteria, treated by a psychosis inpatient service. All participants completed the Brief Psychiatric Rating Scale (BPRS), the Global Assessment of Functioning (GAF) scale, the Frontal Assessment Battery (FAB) and a Data Collection Form. Assessments were made before treatment, during ECT and after treatment.


RESULTS
Statistically significant improvements in both clinical and cognitive outcome were noted after ECT in all patients. Predictors of improvement were sought by evaluating electrophysiological variables measured at three time points (after the third, fifth and seventh ECT sessions). Logistic regression analysis showed that clinical outcome/improvement did not differ by seizure duration, threshold energy level or post-ictal suppression time.


CONCLUSIONS
We found that ictal EEG parameters measured at several ECT sessions did not predict clinical recovery/outcomes. This may be because our centre defensively engages in "very specific patient selection" when ECT is contemplated. ECT does not cause short-term cognitive functional impairment and indeed improves cognition, because symptoms of the schizophrenic episode are alleviated.
Gulnihal Gokce Simsek, M.D., Psychiatry Department, Yozgat State Hospital , Yozgat , Turkey.
Gulnihal Gokce
GG
Simsek
Selma
S
Zincir
Huseyin
H
Gulec
Sevgin
S
Eksioglu
Umit Basar
UB
Semiz
Yasemin Sipka
YS
Kurtulmus
D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D004565:Electroconvulsive Therapy / Q000009:adverse effects / Q000379:methods*; D004569:Electroencephalography; D005071:Evoked Potentials; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology; D016037:Single-Blind Method; D016896:Treatment Outcome
Electroconvulsive therapy; Ictal; Post-ictal suppression time; Schizophrenia; Side-effect; Treatment outcome