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Assessment of oxidative stress markers in multi-episode schizophrenia: a comparative study before and after electroconvulsive therapy and their correlation with clinical improvement

Year: 2026

Type: article

Abstract: This study examined oxidative stress (OS) markers in acute relapse schizophrenia, assessed the impact of electroconvulsive therapy (ECT), and explored correlations with clinical improvement. 110 Han Chinese patients and 55 healthy controls were enrolled. All enrolled patients had multi-episode schizophrenia with a mean illness duration of 11.15 ± 9.11 years. Patients received 8–12 bilateral ECT sessions plus antipsychotics. Serum levels of GSH-Px, MnSOD, CuZnSOD, and CAT were measured before and after ECT. Symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). At baseline, schizophrenia patients showed significantly lower serum levels of GSH-Px, MnSOD, and CAT, while the MnSOD/CuZnSOD ratio was decreased, CuZnSOD levels showed a non‑significant trend as compared to healthy controls. GSH-Px levels were negatively correlated with the PANSS positive subscale scores ( p = 0.007). Following ECT, all PANSS scores significantly decreased (all p < 0.001). Serum levels of GSH-Px, TSOD, CuZnSOD, and CAT increased significantly, while MnSOD levels and the MnSOD/CuZnSOD ratio significantly decreased (all p < 0.01). In responders, changes to OS markers were significant (all p < 0.01). Increases in GSH-Px levels were positively correlated to reductions in the PANSS total score (Bonferroni corrected p = 0.024) and general subscale scores (Bonferroni corrected p = 0.008). Multivariate logistic regression analysis identified the baseline GSH-Px level as an independent potential indicator of clinical improvement ( p = 0.001). Acute relapse schizophrenia shows significant redox imbalance. ECT in combination with antipsychotics modulates antioxidant enzymes, and GSH-Px dynamics correlate with symptom improvement, suggesting its potential as a predictive and monitoring biomarker for ECT outcomes. Not applicable.

Source: BMC Psychiatry

DOI: 10.1186/s12888-026-08437-8