Academic Journal

Electroconvulsive therapy in the manic phase of bipolar disorder: examining oxidative stress and effects of thiol-disulfide homeostasis.

Bibliographic Details
Title: Electroconvulsive therapy in the manic phase of bipolar disorder: examining oxidative stress and effects of thiol-disulfide homeostasis.
Authors: Angın KM; Department of Psychiatry, Bursa City Hospital, Bursa, Türkiye., Önen S; Department of Psychiatry, University of Health Sciences Bursa Yuksek Ihtisas Training And Research Hospital, Bursa, Turkey., Neşelioglu S; Department of Biochemistry, Ankara Bilkent City Hospital, Ankara, Turkey.; Department of Biochemistry, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey., Erel Ö; Department of Biochemistry, Ankara Bilkent City Hospital, Ankara, Turkey.; Department of Biochemistry, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey.
Source: International journal of psychiatry in clinical practice [Int J Psychiatry Clin Pract] 2026 Jun; Vol. 30 (2), pp. 164-171. Date of Electronic Publication: 2026 Jan 08.
Publication Type: Journal Article; Observational Study
Language: English
Journal Info: Publisher: Informa Healthcare Country of Publication: England NLM ID: 9709509 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1471-1788 (Electronic) Linking ISSN: 13651501 NLM ISO Abbreviation: Int J Psychiatry Clin Pract Subsets: MEDLINE
Imprint Name(s): Publication: London : Informa Healthcare
Original Publication: London : Martin Dunitz, c1997-
MeSH Terms: Oxidative Stress*/physiology , Bipolar Disorder*/therapy , Bipolar Disorder*/metabolism , Bipolar Disorder*/blood , Sulfhydryl Compounds*/blood , Sulfhydryl Compounds*/metabolism , Disulfides*/blood , Disulfides*/metabolism , Homeostasis*/physiology , Mania*/therapy , Mania*/metabolism , Electroconvulsive Therapy*, Humans ; Female ; Male ; Adult ; Case-Control Studies ; Cross-Sectional Studies ; Middle Aged
Abstract: Objective: Given evidence for oxidative dysregulation in bipolar disorder, we examined thiol-disulphide balance (TDB) as a redox biomarker and evaluated the impact of electroconvulsive therapy (ECT) on TDB to clarify redox contributions to BD pathophysiology.
Methods: This observational mixed design study comprising cross-sectional case-control comparisons of BD-ECT(n = 31), BD-non-ECT (n = 46), healthy control (n = 42) groups and within-subject repeated-measures assessments across phases (mania, post-ECT where applicable, remission) in bipolar disorder, quantifying native thiol, disulphide, and total thiol to derive TDB ratios, with FDR-adjusted statistics.
Results: Compared with healthy controls, native thiol was lower in both manic and remission phases (e.g., Mania(299.4 ± 81.16) vs. HC(379.91 ± 48.93); p < 0.001), while disulphide was higher (e.g., Remission(22.85 ± 5.07) vs. HC(17.66 ± 4.96); p < 0.001). Within the ECT group, no significant within-patient changes in TDB indices were observed across time points (all p > 0.05).
Conclusion: We observed a shift of thiol-disulphide balance (TDB) towards oxidative predominance in both manic and remission phases of BD with no significant ECT-related modulation of TDB during mania. These findings highlight the need for a comprehensive examination of the impact of oxidative stress on the underlying mechanisms of BD and potential therapeutic mechanisms of ECT.
Contributed Indexing: Keywords: Bipolar disorder; electroconvulsive therapy; oxidative stress; thiol disulphide homeostasis
Local Abstract: [plain-language-summary] In bipolar disorder, thiol–disulphide balance (TDB) is shifted towards oxidation in both mania and remission, indicating persistent redox dysregulation.ECT does not significantly alter TDB during the manic phase.TDB may function as a trait-like biomarker and potential therapeutic target in BD.
Substance Nomenclature: 0 (Sulfhydryl Compounds)
0 (Disulfides)
Entry Date(s): Date Created: 20260108 Date Completed: 20260529 Latest Revision: 20260529
Update Code: 20260530
DOI: 10.1080/13651501.2025.2611924
PMID: 41504214
Database: MEDLINE
Description
ISSN:1471-1788
DOI:10.1080/13651501.2025.2611924