ECT Kept People with Schizophrenia Well Longer Than Other Treatments

Providing electroconvulsive therapy (ECT) to individuals hospitalized with schizophrenia may prolong the time to relapse, according to a study issued by Acta Scandinavica Psychiatrica.

 

APA’s Practice Guideline notes that ECT may be considered for patients with an insufficient response to clozapine and for patients with acute, severe, unmanageable psychotic symptoms, catatonia, or a significant suicide risk. However, there is limited evidence from Western populations on whether ECT reduces risk of relapse in people hospitalized for schizophrenia.

 

• Researchers assessed 351 adults (64% male) in Sweden who had been hospitalized for schizophrenia at least twice from 2011 through 2020 and had received ECT during one stay and non-ECT treatment during another.
• ECT treatment was associated with longer time to hospital readmission or suicide across all periods studied (30 days, 90 days, 180 days, and one year from discharge). Three individuals died by suicide during the nine-year span, so results about suicide should be interpreted with caution.
• For example, ECT treatment was associated with a 34% reduced risk of readmission or suicide within 30 days and 23% reduced risk within one year, compared with non-ECT treatment.

Readmission rates among individuals who received continuation ECT (C-ECT) treatment following discharge were even lower than among those who received just the index series during hospitalization: 7% at 30 days, compared with 24%. However, only 15 patients in the sample were treated with C-ECT.

 

Average hospital stays when ECT was given were much longer than those where no ECT was given (48 days versus 10 days), which may have contributed to the differences in relapse—a secondary analysis found no statistical difference between ECT and non-ECT treatment when patients were matched by length of stay. Other factors associated with schizophrenia relapse, such as adherence, attitude toward treatment, or medication side effects, weren’t accessible in register data.

 

The researchers said that it may be particularly beneficial to try ECT in patients who showed an insufficient response to three or more antipsychotics or those treated with clozapine prior to admission, as these patients showed markedly superior outcomes when given ECT versus non-ECT. However, further studies of the effects of ECT on rates of relapse, readmission, or suicide in schizophrenia are needed.

 

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Linnea Stenmark, et al. Electroconvulsive therapy and time to psychiatric readmission in schizophrenia. Acta Psychiatrica Scandinavica. Published June 5, 2026. doi:10.1111/acps.70115.

 

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