Background Evidence regarding schizophrenia relapse following acute electroconvulsive therapy (ECT) is sparse compared with that for depression, and we have no clear consensus on relapse proportions. We aimed to provide longitudinal information on schizophrenia relapse following acute ECT. Study Design This systematic review and meta-analysis included randomised controlled trials (RCTs) and observational studies on post-acute ECT relapse and rehospitalization for schizophrenia and related disorders. For the primary outcome, we calculated the post-acute ECT pooled relapse estimates at each timepoint (3, 6, 12, and 24 months post-acute ECT) using a random effects model. For subgroup analyses, we investigated post-acute ECT relapse proportions by the type of maintenance therapy. Study Results Among a total of 6413 records, 29 studies (3876 patients) met our inclusion criteria. The risk of bias was consistently low for all included RCTs (4 studies), although it ranged from low to high for observational studies (25 studies). Pooled estimates of relapse proportions among patients with schizophrenia responding to acute ECT were 24% (95% CI: 15-35), 37% (27-47), 41% (34-49), and 55% (40-69) at 3, 6, 12, and 24 months, respectively. When continuation/maintenance ECT was added to antipsychotics post-acute ECT, the 6-month relapse proportion was 20% (11-32). Conclusion Relapse occurred mostly within 6 months post-acute ECT for schizophrenia, particularly within the first 3 months. Relapse proportions plateaued after 6 months, although more than half of all patients could be expected to relapse within 2 years. Further high-quality research is needed to optimise post-acute ECT treatment strategies in patients with schizophrenia.

中文翻译：

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精神分裂症电休克治疗后复发：系统评价和荟萃分析


背景 与抑郁症相比，关于急性电休克治疗 （ECT） 后精神分裂症复发的证据很少，我们对复发比例没有明确的共识。我们旨在提供有关急性 ECT 后精神分裂症复发的纵向信息。研究设计 本系统评价和荟萃分析包括随机对照试验 （RCT） 和关于精神分裂症和相关疾病急性 ECT 后复发和再住院的观察性研究。对于主要结局，我们使用随机效应模型计算了每个时间点（急性 ECT 后 3 、 6 、 12 和 24 个月）的急性 ECT 后合并复发估计值。对于亚组分析，我们按维持治疗类型调查了急性 ECT 后复发比例。研究结果 在总共 6413 条记录中，29 项研究 （3876 名患者） 符合我们的纳入标准。所有纳入的RCTs（4项研究）的偏倚风险始终较低，尽管观察性研究（25项研究）的偏倚风险从低到高不等。对急性 ECT 有反应的精神分裂症患者复发比例的汇总估计分别为 24% （95% CI： 15-35）、37% （27-47）、41% （34-49） 和 55% （40-69） 在 3、6、12 和 24 个月。当急性 ECT 后抗精神病药物联合使用持续/维持 ECT 时，6 个月复发比例为 20% （11-32）。结论 精神分裂症急性 ECT 后 6 个月内多发生复发，尤其是在前 3 个月内。复发比例在 6 个月后趋于稳定，但预计超过一半的患者会在 2 年内复发。需要进一步的高质量研究来优化精神分裂症患者的急性 ECT 后治疗策略。