Evaluating the effect of electroconvulsive therapy (ECT) on post-traumatic stress disorder (PTSD): A systematic review and meta-analysis of five studies

ECT has been proposed as a potential treatment for PTSD. There is a small number of clinical studies to date, but no quantitative review of the efficacy has been conducted. We performed a systematic review and meta-analysis to evaluate the effect of ECT in reducing PTSD symptoms. We followed the PICO and the PRISMA guidelines and searched PubMed, MEDLINE (Ovid), EMBASE (Ovid), Web of Science, and the Cochrane Central Register of Controlled Trials (PROSPERO No: CRD42022356780). A random effects model meta-analysis was conducted with the pooled standard mean difference, applying Hedge's adjustment for small sample sizes. Five within-subject studies met the inclusion criteria, containing 110 patients with PTSD symptoms receiving ECT (mean age 44.13 ± 15.35; 43.4% female). ECT had a small but significant pooled effect on reducing PTSD symptoms (Hedges' g = −0.374), reducing intrusion (Hedges' g = −0.330), avoidance (Hedges' g = −0.215) and hyperarousal (Hedges' g = −0.171) symptoms. Limitations include the small number of studies and subjects and the heterogeneity of study designs. These results provide preliminary quantitative support for the use of ECT in the treatment of PTSD.