[Call for the standardized application of the electroconvulsive therapy sessions in depression]

Electroconvulsive therapy (ECT) is an effective treatment for depression,but it is associated with severe side effects such as memory impairment. The number of ECT sessions is a key determinant of clinical efficacy and adverse effects, such as memory impairment. The frequency of ECT is the main factor affecting clinical efficacy and side effects, yet its clinical application has long relied on an empirical range of 6-12 sessions, with significant controversy and practice heterogeneity, leading to insufficient or excessive treatment. This article systematically analyzes the current status of ECT session, deeply explores the session-effect relationship with efficacy and side effects, and clarifies the key influencing factors of the number of ECT sessions from the perspectives of patients, diseases, and technology. Based on these insights, an integrated standardization path with standardized construction, individualized decision-making, precision technology, and innovative joint models as the core is proposed to promote the transformation of the number of ECT sessions to an evidence-based medicine model, which has important clinical value for optimizing the quality of depression treatment and reducing cognitive risks.