ECT in a Patient with Schizophrenia and Comorbid OCD: New Case Report

Oot  on PubMed, from authors in Taiwan and Australia, is this case report:


Electroconvulsive therapy for obsessive compulsive symptoms in a patient with schizophrenia: a brief report.

Lin CY, Kuo HY, Chang CH, Pan CC, Chu CS, Couper J, Chiang YC.Neurocase. 2023 Nov 9:1-3. doi: 10.1080/13554794.2023.2280274. Online ahead of print. PMID: 37943998


The abstract is copied below:

Comorbid obsessive-compulsive disorder (OCD) is common among patients with schizophrenia. The role of electroconvulsive therapy (ECT) in the treatment of OCD in schizophrenia is unclear. Herein, we present a 45-year-old man who was diagnosed with schizophrenia along with OCD and received ECT due to relapse of psychosis owing to refractive schizophrenia. Together with psychotic symptoms, obvious symptoms of OCD were observed prior to treatment, including obsessive thoughts, difficulty in starting activities, and repetitive and ritualistic behavior. After 12 sessions of ECT, symptoms of schizophrenia and OCD both improved significantly (Positive and Negative Syndrome Scale [PANSS] score decreased from 95 points to 58 points, and Yale - Brown Obsessive-Compulsive Scale [Y-BOCS] score decreased from 29 points to 11 points). Mild aggravation of OCD symptoms was noted 3 months after ECT treatment (Y-BOCS score increased from 11 points to 17 points) without obvious relapse of psychotic symptoms (PANSS score changed from 58 points to 62 points). In conclusion, ECT could be considered as an alternative therapy for patients with schizophrenia and OCD with limited response to pharmacological treatment.

Keywords: Schizophrenia; brain stimulation; electroconvulsive therapy; obsessive-compulsive disorder; treatment resistance.

The report is here.
And here:




This is a straightforward case report. With the exception of the incongruous first sentence of patient history and the lack of any detail about the ECT course, it is reasonably presented. 
In the bigger picture, it should be no surprise that both symptom complexes would improve with ECT. The overlap between the complex motor compulsions and catatonia (my comment, not the authors') is interesting.

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