Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. May 19, 2024; 14(5): 653-660
Published online May 19, 2024. doi: 10.5498/wjp.v14.i5.653
Clinical effects of nonconvulsive electrotherapy combined with mindfulness-based stress reduction and changes of serum inflammatory factors in depression
Zhi-Wen Gu, Chun-Ping Zhang, Li-Ping Chen, Xiong Huang
Zhi-Wen Gu, Li-Ping Chen, Department of Psychiatry, Guangzhou First People's Hospital, South China University of Technology, Guangzhou 510180, Guangdong Province, China
Chun-Ping Zhang, Xiong Huang, Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou HuiAi Hospital), Guangzhou 510370, Guangdong Province, China
Co-corresponding authors: Li-Ping Chen and Xiong Huang.
Author contributions: Gu ZW, Chen LP, and Huang X conceived, designed, and refined the study protocol; Gu ZW, Zhang CP, and Huang X were involved in data collection and analysis; and Gu ZW, Chen LP, and Huang X drafted the manuscript; all authors were involved in the critical review of the results and contributed to, read, and approved the final manuscript. Chen LP and Huang X contributed equally to this work as co-corresponding authors.
Supported by Guangdong Provincial Medical Scientific Research Fund Project, No. B2016109.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Guangzhou HuiAi Hospital (2016005).
Informed consent statement: All study participants or their legal guardians provided written informed consent for personal and medical data collection before study enrolment.
Conflict-of-interest statement: Dr. Chen has nothing to disclose.
Data sharing statement: The datasets used in this study can be obtained from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Ping Chen, MD, Associate Chief Physician, Department of Psychiatry, Guangzhou First People's Hospital, South China University of Technology, No. 1 Panfu Road, Yuexiu District, Guangzhou 510180, Guangdong Province, China. lpingchen@126.com
Received: December 22, 2023
Revised: January 13, 2024
Accepted: April 12, 2024
Published online: May 19, 2024
Processing time: 146 Days and 6.2 Hours
Abstract
BACKGROUND

Depression is a common and serious psychological condition, which seriously affects individual well-being and functional ability. Traditional treatment methods include drug therapy and psychological counseling; however, these methods have different degrees of side effects and limitations. In recent years, nonconvulsive electrotherapy (NET) has attracted increasing attention as a noninvasive treatment method. However, the clinical efficacy and potential mechanism of NET on depression are still unclear. We hypothesized that NET has a positive clinical effect in the treatment of depression, and may have a regulatory effect on serum inflammatory factors during treatment.

AIM

To assess the effects of NET on depression and analyze changes in serum inflammatory factors.

METHODS

This retrospective study enrolled 140 patients undergoing treatment for depression between May 2017 and June 2022, the observation group that received a combination of mindfulness-based stress reduction (MBSR) and NET treatment (n = 70) and the control group that only received MBSR therapy (n = 70). The clinical effectiveness of the treatment was evaluated by assessing various factors, including the Hamilton Depression Scale (HAMD)-17, self-rating idea of suicide scale (SSIOS), Pittsburgh Sleep Quality Index (PSQI), and levels of serum inflammatory factors before and after 8 wk of treatment. The quality of life scores between the two groups were compared. Comparisons were made using t and χ2 tests.

RESULTS

After 8 wk of treatment, the observation group exhibited a 91.43% overall effectiveness rate which was higher than that of the control group which was 74.29% (64 vs 52, χ2 = 7.241; P < 0.05). The HAMD, SSIOS, and PSQI scores showed a significant decrease in both groups. Moreover, the observation group had lower scores than the control group (10.37 ± 2.04 vs 14.02 ± 2.16, t = 10.280; 1.67 ±0.28 vs 0.87 ± 0.12, t = 21.970; 5.29 ± 1.33 vs 7.94 ± 1.35, t = 11.700; P both < 0.001). Additionally, there was a notable decrease in the IL-2, IL-1β, and IL-6 in both groups after treatment. Furthermore, the observation group exhibited superior serum inflammatory factors compared to the control group (70.12 ± 10.32 vs 102.24 ± 20.21, t = 11.840; 19.35 ± 2.46 vs 22.27 ± 2.13, t = 7.508; 32.25 ± 4.6 vs 39.42 ± 4.23, t = 9.565; P both < 0.001). Moreover, the observation group exhibited significantly improved quality of life scores compared to the control group (Social function: 19.25 ± 2.76 vs 16.23 ± 2.34; Emotions: 18.54 ± 2.83 vs 12.28 ± 2.16; Environment: 18.49 ± 2.48 vs 16.56 ± 3.44; Physical health: 19.53 ± 2.39 vs 16.62 ± 3.46; P both < 0.001) after treatment.

CONCLUSION

MBSR combined with NET effectively alleviates depression, lowers inflammation (IL-2, IL-1β, and IL-6), reduces suicidal thoughts, enhances sleep, and improves the quality of life of individuals with depression.

Keywords: Depression, Nonconvulsive electrotherapy, Mindfulness-based stress reduction, Serum inflammatory factors, Clinical effect, Hamilton Depression Scale

Core Tip: Nonconvulsive electrotherapy (NET) is a promising therapy for depression; however, its clinical effects and underlying mechanisms remain unclear. We conducted a retrospective analysis of data from 140 patients with depression. The control group received mindfulness-based stress reduction (MBSR) therapy, whereas the observation group received a combination of MBSR therapy and NET. Alterations in serum inflammatory factor levels have been observed, suggesting that NET exerts a therapeutic effect by modulating inflammatory levels. This study provides valuable insights for future investigations of the mechanisms underlying the role of NET in depression.