Outcomes of Youth Treated With Electroconvulsive Therapy: A Retrospective Cohort Study

ABSTRACT

Background: The use of electroconvulsive therapy (ECT) in children and adolescents is based on a limited evidence base in the medical literature. We report outcomes of a cohort of youth treated with ECT at a single US academic medical center.

Methods: We conducted a retrospective chart review and analysis of all patients aged 18 years and younger who received ECT at the University of Utah from 1985 through 2016. For each patient record, 3 short-term clinical outcomes were assessed: response on the Clinical Global Impressions–Improvement scale, number of treatments administered, and reported side effects. Baseline characteristics were tested as predictors of clinical outcomes.

Results: One hundred seven youth (aged 10–18 years, 46% female) received ECT for a mood disorder, psychotic disorder, catatonia, or neuroleptic malignant syndrome. The most common diagnoses (DSM-IV-TR or DSM-5) were major depressive disorder (76 patients) and bipolar disorder (23 patients). The rate of response (much improved or very much improved) for the entire cohort was 77%. The mean number of treatments administered was 10.5. The most commonly reported side effects were headache (75%) and memory problems (65%). One patient experienced tardive seizures. There were no deaths or serious injuries. Clinical response was not predicted by age, sex, or clinical features (all P > .05).

Conclusions: These data suggest that ECT is a safe and effective treatment for children and adolescents with certain severe psychiatric illnesses. ECT outcomes and side effects were similar to those reported in adults, particularly for patients aged 15–18 years, for whom there are the most data.