The Therapeutic Effect of Electroconvulsive Therapy in Patients With Obsessive-compulsive Disorder: A Quasi-experimental Study.

Abstract

Introduction: Electroconvulsive therapy (ECT) is an effective treatment for some psychiatric disorders. It is postulated that ECT should primarily be considered for patients with treatment-resistant obsessive-compulsive disorder (OCD) in the context of major depression. Therefore, we aimed to evaluate the efficacy of ECT in OCD patients without comorbid psychiatric disorders.

Methods: This quasi-experimental study was conducted on 12 adult patients with severe OCD (Yale-Brown test score above 25) and no comorbid psychiatric disorders referred to a tertiary care hospital for psychiatric disorders. Treatment was administered three times a week for up to three to four weeks (a minimum of 8 sessions and a maximum of 12 sessions). We completed the Yale-Brown test for all patients before ECT, on the day after applying ECT, and two months after the final ECT session to evaluate the effect of therapy.

Results: Yale-Brown patients' Mean±SD significantly decreased after the ECT sessions from 28.08±2.50 to 17.17±3.78 (P=0.043). After treatment, the severity of OCD decreased in all patients and turned to mild and moderate levels in 4 patients (33.3%) and 8 (66.7%), respectively. After two months, the Mean±SD Yale-Brown score slightly increased to 18.08±1.62 (P=0.125), and the severity of OCD in all 12 patients (100%) became moderate. Nevertheless, in none of them, the Yale-Brown score increased and returned to the baseline value in this period. None of the patients developed significant side effects during or after ECT sessions.

Conclusion: ECT was a safe and effective therapeutic strategy for patients with treatment-resistant OCD with no comorbid psychiatric disorders. However, further randomized controlled trials are required to validate the efficacy of ECT for OCD treatment before implementing it in the routine clinical practice.