A majority of inpatients with schizophrenia who were treated with electroconvulsive therapy (ECT) demonstrated clinical improvement, irrespective of whether they were capable of consenting before psychiatric treatment, a study found.
Researchers conducted a chart review of inpatients who received an acute course of ECT from 2010 through 2018 at the Centre for Addiction and Mental Health, Toronto, Canada. Results were published online in Schizophrenia Bulletin.
The study included 159 patients (67%) who were incapable of consent before treatment and 79 (33%) capable patients. Of those, 108 (67.9%) of incapable patients and 52 (65.8%) of capable patients exhibited treatment response.
Researchers also assessed whether incapable patients regained the capacity to consent to treatment during the study. Eight incapable patients (5%) regained that capacity, they reported, and 7 of them consented to further treatment.
Among other findings, 21 (13.2%) incapable patients experienced cognitive impairment, compared with 19 (24.1%) capable patients. Incapable patients were more likely to receive maintenance ECT for at least 6 months, and the groups had similar rates of readmission.
“This study informs clinicians, patients, and substitute decision-makers about the outcomes and challenges of ECT in patients with schizophrenia,” researchers wrote.