Elektrokonvulsionstherapie im Kindes- und Jugendalter

Methfessel, Isabel; Weirich, Steffen; Rothermel, Boris; Crozier, J.; Besse, Matthias; Reinhardt, M.; Buchmann, Johannes; Dück, Alexander; Zilles-Wegner, David; Häßler, Frank; Kölch, Michael; Sandersleben, Henrik Uebel von; Poustka, Luise; Sartorius, Alexander

doi:10.1024/1422-4917/a000793

Cited by 3 publications

(3 citation statements)

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“…This study provided convincing evidence that ECT is effective for adolescents with depression and suicidal ideation, consistent with previous literature. A retrospective analysis of 29 adolescent patients (<18 years; 13 with depressive disorders, 6 with catatonia, and 8 with schizophrenia) treated with ECT at 3 German research centers 29 found that ECT improved outcomes in those who did not respond well to drugs. Moreover, ECT had no serious adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Suicidal Ideation and Electroconvulsive Therapy

Cai

Song

et al. 2023

J ECT

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Objective: Few studies on electroconvulsive therapy (ECT) investigate efficacy and safety on depressive adolescents with strong suicidal ideation. Our study examined adolescents (aged 13-18 years) with major depressive disorder to explore ECT effectiveness in improving suicidal ideation and depressive symptoms, as well as its impact on cognitive function.Methods: This nonrandomized controlled trial enrolled 183 adolescent patients suffering from major depressive disorder. The ECT group (n = 81) was treated with antidepressants and 8 rounds of ECT for 2 weeks. The control group comprised 79 patients treated with antidepressants only. Depressive symptoms, suicidal ideation, and cognitive functions were assessed at baseline (pre-ECT) and at 2 and 6 weeks post-ECT. Results:The ECT group showed significant improvements over control in suicidal ideation from the end of treatment to 6 weeks after (P < 0.001). Depressive symptoms also improved (P < 0.001). Patients treated with ECT demonstrated poorer performance in delayed memory, attention, and language, but these impairments were transient. Thus, ECTwas generally safe in adolescent patients with major depressive disorder.Conclusions: Our findings verified ECT as effective and safe for improving suicidal ideation and depressive symptoms of adolescent patients with major depressive disorder. In addition, partially impaired cognitive function recovered gradually after ECT.

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Section: Discussionmentioning

confidence: 99%

Suicidal Ideation and Electroconvulsive Therapy

Cai

Song

et al. 2023

J ECT

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“…The study was approved by the respective institutional review boards of the 3 institutions. Twenty nine of the 32 included patients reported here have already been published in German 30 …”

Section: Methodsmentioning

confidence: 99%

“…A recent literature research yielded only 24 articles on ECT in child and adolescent psychiatry—aside from individual case reports (Table 1). 12,14,22,30 Altogether, 1096 cases were published internationally. No meta-analyses or randomized controlled studies were found.…”

Section: Review Of Existing Literaturementioning

confidence: 99%

Electroconvulsive Therapy in Children and Adolescents in Germany—A Case Series From 3 University Hospitals

Karl

Methfessel

Weirich

et al. 2022

J ECT

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ObjectiveElectroconvulsive therapy (ECT) is a well-established, safe, and efficacious treatment for severe psychiatric disorders. In children and adolescents, it is used much less frequently than in adults, likely because of a lack of knowledge.MethodsWe retrospectively analyzed all patients aged 12 to 17 years who completed a course of ECT at 3 psychiatric university hospitals in Germany between 2010 and 2020. Clinical Global Impression Severity (CGI-S) scores were assessed based on electronic medical records. Changes in CGI-S scores were assessed using a paired samples t test. Predictors for response and remission were assessed using binomial logistic regression.ResultsWe included 32 patients. The CGI-S scores improved significantly from before to after ECT treatment (6.9 vs 3.9, t = 10.0, P < 0.01). A total of 40.6% of patients responded (CGI ≤ 3) and 21.9% remitted (CGI ≤ 2). The number of ineffective medication trials in the 6 months before ECT treatment was significantly associated with response (odds ratio, 0.54; P = 0.028) and remission (odds ratio, 0.31; P = 0.048). Five patients reported subjective cognitive adverse effects, 2 patients exhibited a prolonged seizure, 1 patient reported headaches, and 1 patient experienced a mild allergic reaction after anesthesia with etomidate. A total of 65.6% of patients experienced no adverse effects at all.ConclusionsThis retrospective analysis found ECT to be effective and safe in children and adolescents irrespective of their main diagnosis. The reported data point to the importance of an early use of ECT for severe psychiatric diseases in child and adolescent psychiatry.

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