Citation

Tor PC, Bin Abdin E, Hadzi-Pavlovic D, Loo C. Psychiatry Res. 2020; 284: e112759.

Affiliation

School of Psychiatry, University of New South Wales, Sydney, Australia; The Black Dog Institute, Sydney, Australia; St George Hospital, Sydney, Australia.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/j.psychres.2020.112759

PMID

31927303

Abstract

Suicide risk in schizophrenia is a significant treatment challenge but there are few approved treatments. Electroconvulsive therapy (ECT) is a highly effective treatment for suicidality in depression but its effect on suicidality in schizophrenia is unclear. We conducted a retrospective naturalistic study of the real-world effect of ECT on expressed suicidality as assessed by item 4 of the 24-item Brief Psychiatric Rating Scale in 113 patients with treatment resistant schizophrenia receiving ECT. 19.5% of patients expressed suicidal ideation pre-ECT of which 86.4% experienced an improvement in expressed suicidality after an average of 10.2 (SD 2.7) sessions of ECT. Changes in suicide scores before and after ECT was examined using a generalized estimating equation (GEE) model which showed that the effect of ECT on suicide was significantly mediated by depression and explained 72.2% of the decreased in expressed suicidality. ECT is effective in decreasing depression and expressed suicidality in patients with schizophrenia and should be considered as a treatment option for managing suicidality and psychosis in patients with treatment resistant schizophrenia.

Copyright © 2020 Elsevier B.V. All rights reserved.

Language: en

Keywords

ECT; Schizophrenia; Suicide