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Protocol for Repetitive Transcranial Magnetic Stimulation with Symptom Provocation to Treat Obsessive-compulsive Disorder
Published on: November 25, 2025
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Electroconvulsive Therapy for Obsessive-Compulsive Symptoms in Schizophrenia Spectrum Disorders: A Systematic Review
Mohamad W Midou1, Abhiraj Sanku1, Austin Lui1
1College of Osteopathic Medicine, Touro University California, Vallejo, USA.
Cureus
|November 3, 2025
Summary
Electroconvulsive therapy (ECT) shows promise for treating obsessive-compulsive symptoms (OCS) in schizophrenia patients. Seven of eleven patients improved, with four achieving remission, suggesting ECT as a potential option for severe cases.
Area of Science:
- Psychiatry
- Neuroscience
Background:
- Obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorder (OCD) frequently co-occur with schizophrenia spectrum disorders.
- Limited research exists on the efficacy of electroconvulsive therapy (ECT) for this specific comorbidity.
Purpose of the Study:
- To systematically review the efficacy of ECT for OCS/OCD in patients diagnosed with schizophrenia spectrum disorders.
Main Methods:
- A systematic literature search was performed across multiple databases.
- Inclusion criteria focused on studies involving patients with both OCS/OCD and schizophrenia spectrum disorders treated with ECT.
- Data from 10 studies, encompassing 11 patients (9 case reports, 1 retrospective study), were analyzed.
Main Results:
- Seven out of eleven patients experienced improvement in OCS following ECT, with four achieving complete remission.
- Two acutely suicidal patients due to OCS/OCD showed remission of suicidality.
- A mean reduction of 29.5±7.7 in Yale-Brown Obsessive Compulsive Scale scores was observed in four patients. Maintenance ECT prevented relapse in three patients. No major adverse effects were reported.
Conclusions:
- ECT may be a beneficial treatment for OCS/OCD in schizophrenia spectrum disorder patients, especially those with treatment-resistant or severe symptoms.
- The current evidence is limited by the small sample size and study designs, necessitating further research.
- Additional studies are required to establish definitive efficacy, safety, and optimal usage protocols for ECT in this population.
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