Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Sep;27(3):236-43.
doi: 10.1097/YCT.0b013e3181faaeca.

A systematic review of the combined use of electroconvulsive therapy and psychotherapy for depression

Shawn M McClintock  1 , Anna R Brandon, Mustafa M Husain, Robin B Jarrett
Affiliations

A systematic review of the combined use of electroconvulsive therapy and psychotherapy for depression

Shawn M McClintock et al. J ECT. 2011 Sep.

Abstract

Objective: Electroconvulsive therapy (ECT) is one of the most effective treatments for severe major depressive disorder. However, after acute-phase treatment and initial remission, relapse rates are significant. Strategies to prolong remission include continuation phase ECT, pharmacotherapy, psychotherapy, or their combinations. This systematic review synthesizes extant data regarding the combined use of psychotherapy with ECT for the treatment of patients with severe major depressive disorder and offers the hypothesis that augmenting ECT with depression-specific psychotherapy represents a promising strategy for future investigation.

Methods: The authors performed 2 independent searches in PsychInfo (1806-2009) and MEDLINE (1948-2009) using combinations of the following search terms: Electroconvulsive Therapy (including ECT, ECT therapy, electroshock therapy, EST, and shock therapy) and Psychotherapy (including cognitive behavioral, interpersonal, group, psychodynamic, psychoanalytic, individual, eclectic, and supportive). We included in this review a total of 6 articles (English language) that mentioned ECT and psychotherapy in the abstract and provided a case report, series, or clinical trial. We examined the articles for data related to ECT and psychotherapy treatment characteristics, cohort characteristics, and therapeutic outcome.

Results: Although research over the past 7 decades documenting the combined use of ECT and psychotherapy is limited, the available evidence suggests that testing this combination has promise and may confer additional, positive functional outcomes.

Conclusions: Significant methodological variability in ECT and psychotherapy procedures, heterogeneous patient cohorts, and inconsistent outcome measures prevent strong conclusions; however, existing research supports the need for future investigations of combined ECT and psychotherapy in well-designed, controlled clinical studies. Depression-specific psychotherapy approaches may need special adaptations in view of the cognitive effects of ECT.

PubMed Disclaimer

References

    1. American Psychiatric Association Task Force on Electroconvulsive Therapy. The Practice of electroconvulsive therapy: Recommendations for treatment, training, and priileging. Washington, DC: American Psychiatric Association; 2001.
    1. Fink M, Taylor MA. Electroconvulsive therapy: Evidence and challenges. Journal of the American Medical Association. 2007;298(3):330–332. - PubMed
    1. Daly JJ, et al. ECT in bipolar and unipolar depression: Differences in speed of response. Bipolar Disorders. 2001;3:95–104. - PubMed
    1. Husain MM, et al. Speed of response and remission in major depressive disorder with acute Electroconvulsive therapy (ECT): A consortium for research in ECT (CORE) report. Journal of Clinical Psychiatry. 2004;65(4):485–491. - PubMed
    1. Lisanby SH. Electroconvulsive Therapy for Depression. New England Journal of Medicine. 2007;357:1939–1945. - PubMed

Publication types

MeSH terms

Substances