Suicidal Ideation and Electroconvulsive Therapy

Abstract

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.

Efficacy and safety of non-invasive brain stimulation in combination with antidepressants in adolescents with depression: a systematic review and meta-analysis

“…Four studies reported changes in HAMD scores before and after treatment ( 32 , 41 , 42 , 44 ). The heterogeneity test showed that there was significant heterogeneity among the included studies ( I 2 = 98.9%, P < 0.01).…”

Efficacy of Electroconvulsive Therapy for the Treatment of Movement Disorders: A Literature Review

“…The efficacy of ECT in treating major depressive symptoms was validated by four additional studies [75][76][77][78].…”

“…The therapy transformed the integrity of the white matter over time, thus diminishing the possibilities of increased seizure activities. One controlled study reported that ECT improved suicidal ideation among major depressive patients [78]. ECT resulted in the improvement of psychiatric symptoms but continued to show progressive deterioration until death by the disorder.…”

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.…”