Use of electroconvulsive therapy in adolescents with schizophrenia in China

Abstract

BackgroundElectroconvulsive therapy (ECT) is an effective treatment for psychiatric disorders such as schizophrenia, major depression and bipolar disorder. However, few studies have addressed the use of ECT in adolescents with schizophrenia. The aims of our study were to investigate the frequency of ECT, and its relationship with clinical and demographic correlates among adolescents with schizophrenia in China.MethodsThe study was a retrospective study and conducted in the Child and Adolescent Psychiatry Department of Beijing Anding Hospital, and adolescents with schizophrenia over a period of 10 years (2007–2016) were enrolled. The demographic and clinical data were collected from the electronic chart management system.ResultsA total of 835 patients were included, 411/835 (49.2%) of the adolescent inpatients diagnosed with schizophrenia were in ECT group. There were significant differences in the sex, age, high risk for aggression and suicide, family history of psychiatric disorders and concomitant psychotropic medication (antidepressants and benzodiazepines) between the ECT and non-ECT groups. Multiple logistic regression analysis revealed that ECT use was independently and positively associated with sex, high risk for suicide.ConclusionsIn a major psychiatric center in China, the use of ECT was common, and reasons for the high use of ECT for adolescent patients in this hospital should warrant urgent investigations.

Electroconvulsive therapy efficacy in adolescents with mental illness: A retrospective comparison

“…In our study, although the efficacy of ECT in the treatment of SCZ was lower than affective disorders, the results showed that the majority of adolescents with SCZ had experienced clinically significant improvement. Wang et al reviewed adolescents with SCZ treated by ECT in China (326 samples), and their results suggested that the response rate was 65%, which was very close to our results (24). A retrospective chart review evaluated the clinical profile of adolescents who had received ECT, the results showed that the rate of remission for SCZ was lower than MDD and mania, which was similar to our results (29).…”

“…A recent study (835 samples) reviewed adolescents with schizophrenia from 2007 to 2016 in a single Chinese academic medical center. This study found that the frequency of ECT use was 49.2% and ECT use was independently and positively associated with gender, and high risk for suicide (24). A retrospective study examined the association between baseline futures and clinical outcomes, the results suggested that ECT is safe and efficacy, but the clinical response was not predicted by demographic data (23).…”

The Safety and Efficacy of Repetitive Transcranial Magnetic Stimulation in the Treatment of Major Depression Among Children and Adolescents: A Systematic Review

“…The practice parameter of the American Association of Child and Adolescent Psychiatry recommends electroconvulsive therapy (ECT) for adolescents in resistant cases of major depression [8]. However, ECT is less frequently used [4,9] due to cognitive side effects, prolonged seizure, and anesthetic complications [4,10]. As a result, there is an increasing interest in novel treatment approaches for major depression.…”

Eletroconvulsoterapia no manejo do risco suicida

“…The frequency of sessions and the duration of treatment depend on the pathology and the patient's response rate, and the placement of the electrodes can be unilateral or bilateral, with bilateral placement appearing to be more effective at lower doses in reducing depressive symptoms, however, can lead to a transient impairment of anterograde memory, reduced with unilateral positioning 1 . The decision for therapy is influenced by side effects, costs and hospital guidelines; the grading of risk depends on the occurrence of comorbidities and the patient's need, and the effectiveness of treatment, after remission of symptoms with ECT, can be maintained with the use of antidepressants or lithium 1,3 .…”

“…Despite being relatively safe and with little long-term negative neuropsychological influence, ECT is considered an invasive treatment and may have cognitive impairment as side effects, mainly transient anterograde memory impairment; delirium; pain and/or musculoskeletal injury, prolonged seizures and complications associated with anesthesia, so the patient must be constantly supervised by the team, with the anesthesiologist, during the procedure 3,4 .…”