Baseline Thyroid-Stimulating Hormone Levels as a Predictor of Electroconvulsive Therapy Response in Obsessive-Compulsive Disorder

Background: Electroconvulsive therapy (ECT) shows potential in treating obsessive-compulsive disorder (OCD), especially in treatment-resistant cases. However, its efficacy, associated factors, and particularly the role of baseline thyroid-stimulating hormone (TSH), remain underexplored. Objective: This study examines ECT’s therapeutic efficacy in OCD patients and assesses baseline TSH levels’ predictive utility to identify biomarkers influencing treatment outcomes. Methods: Fifty-nine OCD patients who received ECT at Shandong Daizhuang Hospital (January 2010 to August 2024) were enrolled. Demographic and clinical data were collected; patients were stratified into responders/nonresponders via the Clinical Global Impressions-Improvement scale. Multivariate logistic regression and receiver operating characteristic (ROC) curve analysis were used to evaluate associations between baseline TSH, other factors, and ECT outcomes. Results: Forty-one patients (69.49%) responded to ECT. Responders and nonresponders had no significant demographic differences. Fluoxetine use (χ 2 =4.274, P =0.039) and baseline TSH ( T =2.997, P =0.004) correlated with outcomes, but only baseline TSH (OR=0.574, P =0.040) was significant in multivariate analysis. ROC showed baseline TSH’s AUC=0.685 (95% CI: 0.525-0.845, P =0.021), with 90.2% sensitivity, 50.0% specificity, and 0.402 Youden index. Conclusion: ECT is effective for OCD in this cohort. Fluoxetine use and baseline TSH correlated with outcomes; lower baseline TSH linked to higher response rates, suggesting it may predict ECT outcomes.