A comprehensive retrospective study regarding the efficacy of electroconvulsive therapy in an adolescent population

Objective: Electroconvulsive therapy (ECT) is defined as an effective treatment method used in treatment-resistant patients with severe psychiatric disorders. However, few writers have been able to draw on any structured research into treatment efficacy in adolescent patient populations. The aim of this study was to examine effectiveness of ECT in an adolescent patient population.

Methods: We retrospectively analyzed the medical records of 717 patients who were administered ECT between 2012 and 2014. 36 of the patients were adolescent, and there were 30 complete patient records available. Adolescents aged between 15-18 years of age were included in the study. Patients who had not been evaluated with scales before and after ECT were excluded from the study. Data were collected using Hamilton Depression Rating Scale (HAM-D), Young Mania Rating Scale (YMRS), Positive and Negative Syndrome Scale (PANSS), and Clinical Global Impression (CGI).

Results: There were 17 girls (56.6%) and 13 boys (43.3%) in the study group; their mean age was 17.23±1.00 years. 3 (10%) of the patients were administered maintenance ECT. According to DSM-IV, 14 patients (%56.6) met the diagnosis criteria for bipolar mood disorder, 10 (n=10 %33.3) for depression, 4 (13.3%) for schizophrenia and 2 (%6.6) for schizoaffective disorder. Indications for ECT were pharmacotherapy resistance (n=10, 33.3%), intense suicidal ideation (n=8, 26.7%), excitation (n=6 20%), catatonia (n=5 16.7%) and pregnancy (n=1 3.3%). All of the pretreatment scale scores were significantly higher than the posttreatment scale scores (p<0.05). After ECT, manic switch was seen in three patients. Mortality was not reported.

Conclusion: The results of this research indicate that ECT is an effective treatment in an adolescent patient population. Clinicians should try to keep in mind ECT as a treatment choice in adolescent patients with severe psychiatric disorders. More research using larger samples is needed to assess the efficacy of ECT in adolescent population.