Impact of electroconvulsive therapy on inflammatory markers in patients with severe mental disorders

Objective: Evaluation of the effects of electroconvulsive therapy (ECT) on systemic inflammatory markers in patients with severe mental disorders and determination of potential clinical predictors of treatment response.

Methods: The current retrospective cohort study included 156 patients with psychotic and mood disorders who underwent ECT. Pre- and post-ECT blood samples were collected to assess inflammatory markers, including C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), and other complete blood count derived indices. Clinical outcomes were measured using the Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression Severity (CGI-S).

Results: Significant reductions in several inflammatory markers were identified, including NLR, monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), CRP and CRP-albumin ratio, following ECT. Both BPRS and CGI-S scores also showed marked improvement post-ECT. Psychotic presentation was identified as a predictor of greater symptom improvement; changes in inflammatory markers were not significantly correlated with clinical outcomes.

Conclusion: ECT can reduce systemic inflammation in patients with severe mental disorders; however, this reduction may not directly correspond to clinical improvement. These findings suggest that inflammation plays a complex role in the therapeutic effects of ECT.