Department of Psychiatry, University of Utah, Salt Lake City, Utah.
Corresponding author: Matthew D. Pierson, MD, 501 Chipeta Way, Salt Lake City, UT 84108 (
J Clin Psychiatry. 2021 Feb 23;82(2):19m13164. doi: 10.4088/JCP.19m13164.
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.
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.
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).
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.
儿童和青少年电抽搐治疗（ECT）的使用基于医学文献中有限的证据基础。我们报告了在一家美国学术医疗中心接受 ECT 治疗的青年患者队列的结果。
我们对 1985 年至 2016 年间在犹他大学接受 ECT 的所有 18 岁以下患者的病历进行了回顾性图表审查和分析。对于每个患者记录，评估了 3 个短期临床结果：临床总体印象-改善量表的反应、治疗次数和报告的副作用。对基线特征进行了测试，以预测临床结果。
107 名青少年（年龄 10-18 岁，46%为女性）因心境障碍、精神病性障碍、紧张症或神经阻滞剂恶性综合征接受 ECT 治疗。最常见的诊断（DSM-IV-TR 或 DSM-5）是重度抑郁症（76 例）和双相情感障碍（23 例）。整个队列的反应率（明显改善或非常明显改善）为 77%。平均治疗次数为 10.5 次。最常见的报告副作用是头痛（75%）和记忆问题（65%）。1 例患者出现迟发性癫痫发作。无死亡或严重伤害。临床反应与年龄、性别或临床特征无关（均 P > .05）。
这些数据表明，ECT 是治疗某些严重精神疾病儿童和青少年的一种安全有效的治疗方法。ECT 的结果和副作用与在成年人中报告的相似，特别是对于 15-18 岁的患者，因为他们的数据最多。
