Individualized hybrid electroconvulsive therapy (i-HECT) shows rapid anti-depressant effect in young patients with depression
6 affiliations
- 1Department of Clinical Psychology, Second People’s Hospital of Huizhou, Huizhou, Guangdong China
- 2Electroconvulsive Therapy Room, Second People’s Hospital of Huizhou, Huizhou, Guangdong China
- 3Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei China
- 4Department of Radiology, Washington University School of Medicine, St. Louis, MO USA
- 5Department of Psychiatric Rehabilitation, Second People’s Hospital of Huizhou, Huizhou, Guangdong China
- 6Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0SZ UK
Abstract
Background: For young patients with depression, electroconvulsive therapy (ECT) is highly effective but causes acute cognitive side effects. We designed a new individualized hybrid electroconvulsive therapy (i-HECT) combines ECT with low-charge electrotherapy (LCE) and individual symptom monitoring to reduce cognitive impairments.
Methods: i-HECT comprised two treatments: ECT and LCE. ECT utilized an energy set of 1.5 times the seizure threshold (ST), while LCE was set at 0.5 ST. The initial session employed standard bilateral ECT. Subsequent sessions involved ECT or LCE, depending on whether meeting the ECT-LCE transition criteria (Montgomery-Åsberg Depression Rating Scale (MADRS) total score < 22 or ≥ 50% reduction), assessed after each session. This trial employed a Simon’s optimal two-stage design with a 3-month follow-up period in 46 young patients (age 16–25) with depression (MADRS ≥ 22).
Results: The intention-to-treat analysis revealed an 80.4% response rate and a 58.7% remission rate, The reduction in MADRS score was 19.1 ± 7.0, with Hedges’ g = 3.29 (95% CI = 2.66 to 3.91). The orientation recovery tests (ORTs) took 22.7 ± 11.3 min after LCEs and 26.0 ± 10.3 min after ECTs. Improvements in cognitive functions were observed after i-HECT treatments and during the 3-month follow-up periods.
Conclusion: In conclusion, our i-HECT protocol shows promise as a simple and rapid treatment option for young patients with depression, with observed improvements in cognitive function.
Trial registration: This trial was registered in the Chinese Clinical Trial Registry (http://www.chictr.org.cn), registration number: ChiCTR2100045682. Date of registration on April 23, 2021.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12888-026-08515-x.
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BibTeX
@article{zeng2026individualized,
title = {{Individualized hybrid electroconvulsive therapy (i-HECT) shows rapid anti-depressant effect in young patients with depression}},
author = {Lun Zeng and Jing-ya Zhang and Jia Li and Mian-mian Chen and Shu-xian Xu and Chen-long Gu and Bai-jian Tan and Xin-hui Xie},
journal = {BMC Psychiatry},
year = {2026},
month = aug,
doi = {10.1186/s12888-026-08515-x},
url = {https://doi.org/10.1186/s12888-026-08515-x},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Individualized hybrid electroconvulsive therapy (i-HECT) shows rapid anti-depressant effect in young patients with depression
AU - Lun Zeng
AU - Jing-ya Zhang
AU - Jia Li
AU - Mian-mian Chen
AU - Shu-xian Xu
AU - Chen-long Gu
AU - Bai-jian Tan
AU - Xin-hui Xie
PY - 2026
DA - 2026/08/11
JO - BMC Psychiatry
DO - 10.1186/s12888-026-08515-x
UR - https://doi.org/10.1186/s12888-026-08515-x
AB - Background: For young patients with depression, electroconvulsive therapy (ECT) is highly effective but causes acute cognitive side effects. We designed a new individualized hybrid electroconvulsive therapy (i-HECT) combines ECT with low-charge electrotherapy (LCE) and individual symptom monitoring to reduce cognitive impairments. Methods: i-HECT comprised two treatments: ECT and LCE. ECT utilized an energy set of 1.5 times the seizure threshold (ST), while LCE was set at 0.5 ST. The initial session employed standard bilateral ECT. Subsequent sessions involved ECT or LCE, depending on whether meeting the ECT-LCE transition criteria (Montgomery-Åsberg Depression Rating Scale (MADRS) total score < 22 or ≥ 50% reduction), assessed after each session. This trial employed a Simon’s optimal two-stage design with a 3-month follow-up period in 46 young patients (age 16–25) with depression (MADRS ≥ 22). Results: The intention-to-treat analysis revealed an 80.4% response rate and a 58.7% remission rate, The reduction in MADRS score was 19.1 ± 7.0, with Hedges’ g = 3.29 (95% CI = 2.66 to 3.91). The orientation recovery tests (ORTs) took 22.7 ± 11.3 min after LCEs and 26.0 ± 10.3 min after ECTs. Improvements in cognitive functions were observed after i-HECT treatments and during the 3-month follow-up periods. Conclusion: In conclusion, our i-HECT protocol shows promise as a simple and rapid treatment option for young patients with depression, with observed improvements in cognitive function. Trial registration: This trial was registered in the Chinese Clinical Trial Registry (http://www.chictr.org.cn), registration number: ChiCTR2100045682. Date of registration on April 23, 2021. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12888-026-08515-x.
SN - 1471-244X
ER -