Electroconvulsive therapy efficacy in adolescents with mental illness: A retrospective comparison

Abstract

BackgroundThere is limited evidence on the efficacy of electroconvulsive therapy (ECT) in adolescents with mental illness. The present study reported outcomes of adolescents with mental illness treated with ECT aimed at providing evidence for large-scale feasibility.ObjectivesThe primary objective of this trial was to examine the differences in demographic and clinical data between responders and non-responders. The secondary objective was to determine whether ECT produced differential readmission rates, the burden of oral medication, and social function in responders and non-responders in the long term.MethodsPatients aged 14–18 years diagnosed with schizophrenia (SCZ), major depressive disorder (MDD), or bipolar disorder (BD) who received ECT between 2015 and 2020 were included in the study. Demographic and clinical data were compared, and both short-term and long-term outcomes were assessed: response on the Clinical Global Impressions-Improvement scale and readmission at follow-up. The independent-sample t–test was used to compare the continuous variables and the X2 test was used to compare the dichotomous variables with statistical significance at P ≤ 0.05.ResultsFour hundred ten adolescents (aged 14–18 years, 53.90% female) received ECT for SCZ, MDD, and BD. The response rate for SCZ, MDD, and BD were 65.61, 78.57, and 69.95%, respectively. Both SCZ (P = 0.008) and BD (P = 0.008) groups had a significant elder age in responders than in non-responders. Besides that MDD responders had a significantly larger number of ECT sessions than non-responders (P = 0.046), the study failed to find a significant difference in other ECT parameters. A significantly higher proportion of readmission was found in BD non-responders than in responders (P = 0.029), there was no difference in the rate of readmission in other diagnostic groups.ConclusionsThese data suggested that ECT is an effective treatment for adolescents with severe mental illness, and the rate of readmission was low in the long term. The present study supports that large-scale systematic studies are warranted for further investigation of the response rate of ECT for treating adolescents with mental illness.

Electroconvulsive therapy for adolescents with severe depressive episode and suicidality: retrospective comparison between responders and non-responders

“…This consistent reduction in risk was particularly stable within the 8 to 12 session range. Though other retrospective studies conducted in different regions of China did not provide the overall average ECT sessions for direct comparison between effective and ineffective groups, they did observe similar disparities (e.g., the effective group averaged 7.4 sessions versus an ineffective group averaged 6.6 sessions, P = 0.046) [ 11 ]. An Israeli retrospective study further emphasized this pattern, revealing that a significant number of patients only responded to treatment after more than 12 ECT sessions [ 12 ].…”

“…This method is capable of significantly reducing both symptoms of depression and the risk of suicide [ 7 ], and its use among teenagers has been consistently growing. Recent retrospective research from various countries has shown that the response rates to ECT for adolescent major depression range from 72 to 78.6% [ 8 – 11 ]. However, approximately one-third of patients fail to respond to this therapy.…”

“…Research on adolescents is notably scarce, and the few existing studies indicate that among patients with depression undergoing ECT, features accompanying psychotic symptoms are correlated with higher relief rates [ 20 ]. Additionally, female major depressive cases with nonsuicidal self-injury (NSSI) [ 21 ], as well as those with fewer ECT sessions [ 11 ], may correlate with unsatisfactory outcomes, but many more contributing factors await clarification.…”

A naturalistic study of the efficacy and acceptability of rTMS in treating major depressive disorder in Australian youth

“…Moreover, pharmacotherapies can produce more frequent and significant side effects in youth compared to adults, including increased suicide ideation 8 . Meanwhile, Electroconvulsive Therapy (ECT) is prescribed only in rare cases due to safety concerns of seizure induction in the developing brain 9 . Overall, there are few safe, well tolerated, and effective treatment options available for youth with (severe) depression and suicidal ideation.…”

Electroconvulsive therapy for adolescents with major depressive disorder and suicidality：retrospective comparison between responders and nonresponders

“…This method is capable of signi cantly reducing both symptoms of depression and the risk of suicide 7 , and its use among teenagers has been consistently growing. Recent retrospective research from various countries has shown that the response rates to ECT for adolescent MDD range from 72% to 78.6% [8][9][10][11] . However, approximately one-third of patients fail to respond to this therapy.…”