Kirlioglu Balcioglu Simge Seren, Kilictutan Amine, Ozer Duygu, Guclu Oya, Namli Mustafa Nuray
Department of Psychiatry, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkiye; Hamidiye Institute of Health Sciences, University of Health Sciences, Istanbul, Turkiye.
Department of Psychiatry, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkiye.
J Psychiatr Res. 2025 Feb;182:297-303. doi: 10.1016/j.jpsychires.2025.01.036. Epub 2025 Jan 16.
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.
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).
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.
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.
评估电休克治疗（ECT）对重度精神障碍患者全身炎症标志物的影响，并确定治疗反应的潜在临床预测因素。
本回顾性队列研究纳入了156例接受ECT治疗的精神病性和情绪障碍患者。在ECT治疗前后采集血样，以评估炎症标志物，包括C反应蛋白（CRP）、中性粒细胞与淋巴细胞比值（NLR）以及其他全血细胞计数衍生指标。使用简明精神病评定量表（BPRS）和临床总体印象严重程度量表（CGI-S）来衡量临床结局。
ECT治疗后，多项炎症标志物显著降低，包括NLR、单核细胞与淋巴细胞比值（MLR）、血小板与淋巴细胞比值（PLR）、CRP以及CRP与白蛋白比值。BPRS和CGI-S评分在ECT治疗后也显示出明显改善。精神病性表现被确定为症状改善更明显的预测因素；炎症标志物的变化与临床结局无显著相关性。
ECT可减轻重度精神障碍患者的全身炎症；然而，这种减轻可能与临床改善无直接对应关系。这些发现表明炎症在ECT的治疗效果中起复杂作用。
