Factors Associated With Utilization of Electroconvulsive Therapy During Psychiatric Hospitalization Among Children and Adolescents in China

Abstract

Purpose: Based on a nationally representative sample in China, we examined the demographic and clinical correlates of utilization of electroconvulsive therapy (ECT) in child and adolescent (C/A) patients younger than 18 years during psychiatric hospitalization.Methods: As part of a national survey, 41 provincial tertiary psychiatric hospitals in mainland China were selected. Data from 196 C/A patients who were discharged from these psychiatric hospitals from March 19 to 31, 2019, were retrieved and analyzed. Results:(1) The overall rate of ECT among C/A patients during psychiatric hospitalization was 15.6% (n = 30). ( 2) Between ECT and non-ECT groups, significant differences were found in sex, age, length of stay, Global Assessment of Functioning at admission, treatment outcome, and self-injurious behavior during hospitalization, and the ratio of marked improvement on discharge. (3) Multiple logistic regression analysis revealed that ECT use was independently and positively associated with an older age, male sex, lower Global Assessment of Functioning, and self-injurious behavior during hospitalization. Conclusions:The frequency of ECT use was relatively frequent in C/A patients during psychiatric hospitalization in our nationally representative sample in China. Developing more specific and operational criteria for the use of ECT for C/A patients is needed to provide guidance for the optimal use of ECT in this patient population.

Editor's Roundup for Issue 3 of 2023

“…Against this backdrop, we welcome the paper by Swartz, which uses structural modeling to show that intracerebral voltage drops, and changes in temperature are negligible 1 . This issue also features 2 papers from China regarding ECT in adolescents, which report that self-injurious behavior is a predictor of ECT use and that prescription of ECT is superior to psychotropics alone in lowering suicidal ideation in adolescents 2,3 . Luccarelli et al 4 reconfirm the decline in ECT use in US hospitals during early COVID-19 pandemic, whereas a global survey by Sarma et al 5 shows that suicide deaths were related to loss of access to ECT during the pandemic.…”

“…1 This issue also features 2 papers from China regarding ECT in adolescents, which report that self-injurious behavior is a predictor of ECT use and that prescription of ECT is superior to psychotropics alone in lowering suicidal ideation in adolescents. 2,3 Luccarelli et al 4 reconfirm the decline in ECT use in US hospitals during early COVID-19 pandemic, whereas a global survey by Sarma et al 5 shows that suicide deaths were related to loss of access to ECT during the pandemic. Finally, Takotsubo cardiomyopathy is a rare and potentially dangerous complication of ECT, and because of its rarity, ECT providers may not understand whether it is safe to reintroduce ECT.…”