The use of the stabilization period in ECT research in schizophrenia: I. A pilot study.

Electroconvulsive therapy (ECT) has been used to control schizophrenic patients since 1938. At the present time, the role of ECT treatment in schizophrenia is still controversial. This is because of the paucity of research of both acute and long term ECT uses, which has also been characterized by serious methodological flaws. The main problems of these difficulties are: 1) lacking standard of ECT techniques, 2) using heterogeneous groups of patients, and, 3) no proper outcome measurements. The author hypothesized the 3-week-stabilization-period in order to use as: 1) a response criterion to delineate the ECT responders from non-responders, 2) a screening method to obtain a homogeneous group of patients for continuation treatment study in schizophrenia, and 3) a method to terminate acute ECT treatment. This pilot study was done prospectively on 35 schizophrenic patients suffering psychotic exacerbations. Twenty three patients passed the stabilization period and there were a clear distinction between responders and non-responders. This study could identify a homogeneous group of patients, which might be suitable for continuation treatment study. Critical questions regarding the ECT methodological issues are extensively discussed.