Evaluation of Electroconvulsive Therapy in Adolescents With Major Depressive and Bipolar Disorders: A Retrospective Analysis

J ECT. 2023 Jun 1;39(2):111-116. doi: 10.1097/YCT.0000000000000894. Epub 2022 Nov 22.

Abstract

Objective: This study aims to provide an evaluation of electroconvulsive therapy (ECT) in hospitalized adolescents with major depressive and bipolar disorders by examining its treatment outcomes as well as comparing it with outcomes of hospitalized patients, treated as usual (TAU).

Methods: This is a retrospective study based on medical records documented between April 2011 and December 2017 from Beijing An Ding Hospital. Patients were diagnosed according to the International Classification of Diseases, Tenth Revision . The study included 288 inpatients, with 2 groups of 171 patients treated by ECT and 117 TAU. The primary outcome was measured using the severity subscale of Clinical Global Impression. Mann-Whitney U test, χ2 test, and linear regression with mixed models were used to analyze the data.

Results: Symptom severity reduced significantly for both groups ( β = -0.62, t975.93 = -20.54, P < 0.001). The TAU group was associated with lower score on the severity subscale of Clinical Global Impression ( β = 0.28, t980.32 = 8.36, P < 0.001). The ECT group had a higher remission rate (28.65%) than the TAU group (16.24%), but the time required for remission was longer ( U [ NECT = 49, NTAU = 19] = 615, z = 2.10, P = 0.04). Adverse events of ECT were barely observed.

Conclusion: Electroconvulsive therapy is an efficacious and safe treatment for adolescents. However, as the superiority in efficacy was not evident in ECT group, its prescription should be prudently considered for younger patients who respond well to other treatments.

MeSH terms

  • Adolescent
  • Bipolar Disorder* / drug therapy
  • Depressive Disorder, Major* / drug therapy
  • Electroconvulsive Therapy* / adverse effects
  • Humans
  • Retrospective Studies
  • Treatment Outcome