Impact of Electroconvulsive Therapy on Hematological Inflammatory Markers in Patients with Psychiatric Disorders: A Prospective Cohort Study

Psychiatric disorders are associated with chronic low-grade inflammation, which may be reflected in altered hematological parameters. Electroconvulsive therapy (ECT) is an effective treatment for various mental illnesses, yet its immunomodulatory effects on peripheral inflammatory markers remain incompletely understood. This study aimed to investigate changes in hematological inflammatory markers following ECT in patients with psychiatric disorders. This prospective cohort study enrolled 137 psychiatric patients indicated for ECT. Complete blood counts were obtained one day before the first and 24 hours after the fourth ECT session. Parameters analyzed included total and differential leukocyte counts, red blood cell indices, platelet indices, and inflammatory ratios. Significant reductions were observed in total leukocyte count, neutrophils, lymphocytes, monocytes, hemoglobin, packed cell volume, and red cell distribution width after four ECT sessions compared to baseline (all p<0.05). Platelet distribution width increased significantly (p<0.001), while other platelet indices and inflammatory ratios (neutrophil-to-lymphocyte, platelet-to-lymphocyte) remained unchanged. In conclusion, ECT is associated with modest alterations in hematologic parameters indicative of an immunomodulatory effect, without inducing clinically significant cytopenias.