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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0894

Are we using electroconvulsive therapy too late? A narrative review and proposal for earlier integration in depression and psychosis

ARE WE USING ELECTROCONVULSIVE THERAPY TOO LATE? A NARRATIVE REVIEW AND PROPOSAL FOR EARLIER INTEGRATION IN DEPRESSION AND PSYCHOSIS

Delays in the use of electroconvulsive therapy stem more from stigma, inadequate training, and misconceptions than from clinical considerations, and current evidence supports its earlier use in selected patients.

The aim is to review the current evidence on the early use of electroconvulsive therapy (ECT) in depression and psychosis, identify barriers to its implementation, and propose criteria for its earlier integration into current treatment algorithms. A narrative review of the literature published between 2015 and 2025 was conducted using PubMed, the Cochrane Library, and major clinical guidelines; clinical reviews, meta-analyses, real-world studies, and evidence on continuation and maintenance ECT were included. The findings indicate that ECT offers high efficacy and rapid improvement in severe depression, particularly in psychotic depression, catatonia, and treatment-resistant episodes; modern techniques reduce cognitive adverse effects while maintaining efficacy. Current evidence suggests that psychotic symptoms, catatonia, suicidal ideation, compromised nutritional status, and severe psychomotor retardation warrant earlier consideration of ECT. Continuation and maintenance ECT have been reported to be associated with lower rehospitalization rates and better long-term outcomes. In conclusion, ECT is a safe, rapid, and highly effective treatment for severe depressive and psychotic disorders; delays in its use appear to be associated more with cultural barriers, stigma, inadequate training, and persistent misconceptions than with clinical considerations. The authors suggest that early use in selected patients with psychotic features, catatonia, suicide risk, severe functional impairment, or nutritional problems may shorten illness duration, enhance functional recovery, and improve inpatient care.

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