Electroconvulsive therapy (ECT) is a widely used treatment for severe and treatment-resistant depression, with high efficacy but considerable interindividual variability of response. The neurophysiological mechanisms underlying ECT's antidepressant effects, particularly the role of seizure duration, remain unclear. This exploratory study investigates how EEG-measured seizure duration influences depressive symptomatology. We retrospectively analyzed data from 53 participants with depressive symptoms (MADRS ≥21) who underwent ECT at the interventional psychiatry unit of the Lausanne University Hospital (CHUV) between November 2023 and April 2025. MADRS scores were assessed at baseline and 6 weeks after ECT. Seizure duration was categorized into 3 groups: short (25 to 39s), medium (40 to 59s), and long (≥60s). Statistical tests, including the Kruskal-Wallis and multiple linear regression, were performed to assess the differences in MADRS score changes across these groups. In addition, we conducted exploratory analyses at the symptom cluster level in MADRS score changes. Participants in the medium seizure duration group (40 to 59s) exhibited the greatest overall improvement in MADRS scores, including a significant reduction in the anxiety and vegetative symptoms cluster. In contrast, for affective and anhedonic symptoms and hopelessness symptoms, the difference between the seizure duration categories did not reach statistical significance. This study identifies an optimal seizure duration window (40 to 59s) as most effective in reducing symptom severity, as measured by MADRS and its symptom cluster factors. Further research is needed to better understand the complex relationship between seizure dynamics and ECT outcomes.

Electroconvulsive therapy (ECT) shows potential in treating obsessive-compulsive disorder (OCD), especially in treatment-resistant cases. However, its efficacy, associated factors, and particularly the role of baseline thyroid-stimulating hormone (TSH), remain underexplored. This study examines ECT's therapeutic efficacy in OCD patients and assesses baseline TSH levels' predictive utility to identify biomarkers influencing treatment outcomes. Fifty-nine OCD patients who received ECT at Shandong Daizhuang Hospital (January 2010 to August 2024) were enrolled. Demographic and clinical data were collected; patients were stratified into responders/nonresponders via the Clinical Global Impressions-Improvement scale. Multivariate logistic regression and receiver operating characteristic (ROC) curve analysis were used to evaluate associations between baseline TSH, other factors, and ECT outcomes. Forty-one patients (69.49%) responded to ECT. Responders and nonresponders had no significant demographic differences. Fluoxetine use (χ2=4.274, P=0.039) and baseline TSH (T=2.997, P=0.004) correlated with outcomes, but only baseline TSH (OR=0.574, P=0.040) was significant in multivariate analysis. ROC showed baseline TSH's AUC=0.685 (95% CI: 0.525-0.845, P=0.021), with 90.2% sensitivity, 50.0% specificity, and 0.402 Youden index. ECT is effective for OCD in this cohort. Fluoxetine use and baseline TSH correlated with outcomes; lower baseline TSH linked to higher response rates, suggesting it may predict ECT outcomes.

Multiple chemical sensitivity is a nociplastic pain syndrome whereby individuals develop adverse somatic symptoms following exposure to various odorants and chemicals. The condition is debilitating, and optimal management is unclear. Electroconvulsive therapy has proven effective for management, but utilization remains low. Here is described a patient with multiple chemical sensitivity who was treated with ultra-brief pulse right unilateral electroconvulsive therapy, who also met Mahgoub's criteria for melancholic depression. The authors suggest that Mahgoub's clinical criteria for melancholia may prove useful for identifying cases of multiple chemical sensitivity that are responsive to electroconvulsive therapy.

Electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), and transcranial direct current stimulation (tDCS) are widely used neuromodulatory interventions for psychiatric disorders. Despite their clinical effectiveness, perceptions and stigma associated with these therapies among caregivers remain a concern, influencing treatment acceptance. This study aimed to estimate the perception and stigma associated with ECT, rTMS, and tDCS among primary caregivers of patients receiving these therapies. A cross-sectional comparative study was conducted at the Department of Psychiatry of a Tertiary Care Centre of North India involving 99 primary caregivers whose ages ranged 18 to 60 years and who are staying with the patient for at least 1 year, equally distributed across the 3 therapy groups (ECT, rTMS, and tDCS). Participants were selected using purposive sampling. Data were collected using validated tools: Brain Stimulation Therapy Perception Questionnaire (BSTPQ) and Brain Stimulation Therapy Stigma Questionnaire (BSTSQ). Caregivers of patients undergoing rTMS and tDCS reported more favorable perceptions and lower stigma compared with ECT caregivers. Statistically significant differences were found between ECT and rTMS groups. A moderate negative correlation was observed between perception and stigma (r=-0.482, P<0.01). Newer therapies like rTMS and tDCS are perceived more positively than ECT. Education and awareness play a critical role in reducing stigma and improving acceptance among caregivers.

First aim was to demonstrate feasibility of continuous noninvasive blood pressure monitoring using the ClearSight System (Edwards Lifesciences Corp) in the setting of electroconvulsive therapy (ECT). Second aim was to evaluate the hemodynamic changes over multiple ECT sessions, allowing prediction and preemptive treatment of hemodynamic changes to reduce cardiovascular stress in subsequent sessions. In a subset of an ongoing RCT, patients' hemodynamic parameters were recorded using the ClearSight System™ from induction of anesthesia for up to 10 minutes. One hundred forty-nine sessions in 14 patients were recorded. Hemodynamic monitoring using the ClearSight System was feasible in all patients with limitation of poor peripheral perfusion due to Raynaud syndrome in one patient and recording gaps in case of poor muscle relaxation. Hemodynamic patterns varied widely between individuals, but were comparable over multiple ECT sessions. Individual hemodynamic reactions can be precisely assessed using the ClearSight System with only minor limitations. Given the similar hemodynamic reaction over repeated sessions, a single measurement can be used to predict subsequent reactions and to preemptively treat cardiovascular changes without the need to use costly consumables over multiple sessions.

High-definition transcranial direct current stimulation (HD-tDCS) offers targeted neuromodulation for neurological disorders. This case study reports its use in a 10-year-old boy with childhood disintegrative disorder and sensory hyposensitivity. After localizing deficits using auditory steady-state response with a Geodesic Transcranial Electrical Neuromodulation system, 20 HD-tDCS sessions were delivered to the left primary auditory cortex over 10 days. After treatment, Autism Treatment Evaluation Checklist scores showed a 66% improvement, with sensory gains in auditory (26%) and proprioceptive (50%) domains, sustained at 1-month, 3-month and 6-month follow-ups. The intervention was well-tolerated with no adverse effects, demonstrating HD-tDCS's potential as a viable treatment for sensory deficits in childhood disintegrative disorder.