The Practice of Electroconvulsive Therapy in Children and Adolescents in the Czech Republic

Abstract

Objectives:The aim of this study was to describe the practice of electroconvulsive therapy (ECT) in child and adolescent patients in the Czech Republic. Methods:We conducted a mail questionnaire survey among Czech facilities associated with the Association of Child and Adolescent Psychiatry, and university hospitals with inpatient psychiatric wards, focused on the practice of ECT between 2013 and 2017 in patients younger than 18 years.Results: Of 18 approached facilities, 13 had access to ECT, and only 6 used ECT on 16 patients. The most common diagnosis was schizophrenia or related disorders (68.75% of patients), and the most common reason for ECTwas catatonic symptoms (37.5%). The most common ECT methodology was bitemporal electrode placement with brief-pulse current (62.5%). In 2 patients, ECTwas terminated because of ineffectiveness and in 1 patient because of adverse reaction. In other patients, ECT ended after achieving a clinical effect. The most common adverse effect was transient memory impairment in a quarter of the patients. The number of pharmacological treatment attempts before ECT significantly correlated with hospitalization length. Conclusions:The utilization of ECT among children and adolescents was low. It was usually used in severe conditions after several pharmacological treatment attempts, which may indicate reluctance among providers to use this modality. A number of pharmacological attempts were associated with longer hospitalizations. In the majority of patients, ECT was effective and safe. On the other hand, the monitoring of cognitive adverse effects was insufficient and could be improved.

Electroconvulsive therapy portrayal in contemporary video games

“…It is important to state here that there were real-life incidents of ECT malpractice, some not that far in the past, such as the scandalous usage of ECT in a group of young students allegedly suffering from "video games addiction" in China (14). It is important to note that nowadays, ECT is applied under a brief general anesthesia in developed countries, has specific indications (pharmaco-resistant affective and psychotic disorders) and in principle requires consent from the patient (16)(17)(18)(19). The application of ECT without the patient's consent is not common and constitutes life-threating conditions, such as syndrome of catatonia or severe psychotic illnesses with malnourishment (20).…”

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

“…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 metaanalyses or randomized controlled studies were found.…”

Altered Regional Homogeneity and Amplitude of Low-Frequency Fluctuations Induced by Electroconvulsive Therapy for Adolescents with Depression and Suicidal Ideation

“…For its use on adolescents, it had been supported by the American Academy of Child and Adolescent Psychiatry (AACAP) since 2004 [ 12 ]. However, due to restrictions on research on adolescents and legal limitations [ 13 , 14 ], few large studies of ECT on adolescents are available, nonetheless, many studies still demonstrated that ECT could be considered amongst MDD adolescents accompanied by SI/SA [ 15 , 16 ].…”