ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Molecular Psychiatry
This article is part of the Research TopicMechanisms and Non-Pharmacological Interventions for Adolescent Mood DisordersView all 9 articles
Clinical Implications of Admission Anemia for Electroconvulsive Therapy Planning in Adolescent Major Depressive Disorder: Identifying Vulnerable Subgroups with Poorer Response
Provisionally accepted
- 1First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- 2University-Town Hospital of Chongqing Medical University, Chongqing, China
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Background: Major depressive disorder (MDD) represents a grave worldwide concern, particularly afflicting the adolescent population. Electroconvulsive therapy (ECT) is widely regarded as a gold-standard intervention for severe forms of MDD, although treatment response varies considerably among individuals. Growing evidence suggests that hematological parameters may influence therapeutic outcomes. This study sought to examine the link between admission anemia and response to ECT treatment. Methods: We analyzed 381 adolescent MDD patients who underwent ECT, comparing demographic and hematological indicators between responders and non-responders. Subgroup analyses were conducted based on gender and depressive subtypes. Results: Among the 381 patients treated with ECT, 272 (71.4%) were classified as responders. Non-responders showed significantly lower baseline hemoglobin levels compared to responders (mean ± SD: 119.0 ± 9.7 vs. 128.7 ± 13.1, p < 0.001). Analysis identified a significant link between hemoglobin levels at admission and the percentage improvement on the HAMD-17 (r = 0.231, p < 0.001). Following confounder adjustment in a binary logistic regression model, anemia at admission was correlated with a lower probability of ECT response [OR (95% CI): 4.051 (2.399-6.840), p < 0.001]. Females and patients with psychotic depression were particularly more susceptible to the impact of admission anemia. Conclusion: Admission anemia is associated with poorer ECT efficacy in adolescent MDD patients. Assessing baseline hemoglobin levels may help optimize ECT treatment planning, especially in female patients and those with psychotic depression.
Keywords: Major Depressive Disorder, Electroconvulsive Therapy, Anemia, Adolescent, treatment outcome
Received: 05 Sep 2025; Accepted: 18 Dec 2025.
Copyright: © 2025 Geng, Xu, Gou, Wang, Chen, Hong and Kuang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Li Kuang
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