Electroconvulsive Therapy-Related Anxiety and Its Associations With Depressive Symptoms and Well-Being

Objectives: This study examined the relationships between electroconvulsive therapy (ECT)-related anxiety, psychological well-being, and depressive symptoms. Methods: A cross-sectional study was conducted in 2025 in Mashhad, Iran, among 287 patients with a history of or currently undergoing ECT. Data were collected using self-report measures: the ECT-related anxiety questionnaire (ERAQ), the 9-item patient health questionnaire (PHQ-9), and the 5-item WHO Well-Being Index (WHO-5). Participants were recruited through convenience sampling. Inclusion criteria were age 18 years or older, confirmed psychiatric diagnosis, prior or ongoing ECT, and full consciousness. Individuals with communication difficulties, impaired memory or judgment, or aggressive behaviors preventing cooperation were excluded. Results: Mean scores for ECT-related anxiety, depressive symptoms, and psychological well-being were 32.74 (SD=9.46), 9.45 (SD=5.40), and 29.27 (SD=20.37), respectively. ECT-related anxiety correlated positively with depressive symptoms ( r =0.381, P <0.001) and negatively with psychological well-being ( r =−0.453, P <0.001). In multiple regression controlling for demographic variables, depressive symptoms (β=0.139, P =0.021) and psychological well-being (β=−0.195, P =0.002) remained significant predictors, explaining 25.4% of the variance (Adjusted R ²=0.254). Demographic variables were not significant. Conclusions: ECT-related anxiety is influenced by depressive symptom severity and psychological well-being. Evaluating and managing these factors before treatment may help enhance patients’ experiences with ECT.