A Retrospective Analysis of the Impact of Electroconvulsive Therapy on Anxiety Symptoms in Patients With Treatment-Resistant Depression.

Background: Electroconvulsive therapy (ECT) is an effective treatment for treatment-resistant depression (TRD). There are limited data on the improvement of anxiety symptoms in patients receiving ECT for TRD.

Objective: The aim of the study was to examine the extent to which anxiety symptom severity improves, relative to improvements in depressive symptoms, in TRD patients receiving an acute course of ECT.

Methods: A retrospective chart review of 117 TRD patients who received an acute ECT course in a naturalistic outpatient setting was conducted. Symptomatic response was measured using the Beck Depression Inventory II and Generalized Anxiety Disorder 7 Scale. Two generalized estimating equation models assessed the degree of change in anxious symptoms relative to the change in depressive symptoms.

Results: Both depression (-0.09, P < 0.001) and anxiety (-0.08, P < 0.001) improved after ECT treatment, with a greater standardized decrease for symptoms of depression. Higher levels of anxiety over the treatment (-0.42, P < 0.001) were associated with smaller antidepressant improvements.

Conclusions: ECT may improve symptoms of anxiety in patients with TRD. Anxiety symptoms show a favorable trajectory of improvement, though to a lesser extent, relative to changes in symptoms of depression. Higher symptoms of anxiety throughout the treatment course may be a negative predictor of antidepressant response in ECT.