Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Gen Hosp Psychiatry. 2023 May-Jun;82:95-100. doi: 10.1016/j.genhosppsych.2023.03.012. Epub 2023 Mar 26.
Electroconvulsive therapy (ECT) devices are classified as class II (moderate risk) for the treatment of depressive disorders and catatonia in patients aged 13 and older, but it is unknown how often the treatment is utilized by child and adolescent patients. The aim of this study was to examine the demographics of child and adolescent hospitalizations involving ECT, the medical and psychiatric comorbidities of these hospitalizations, and the overall number of treatments administered per hospitalization.
The 2019 Kids' Inpatient Database, a national sample of pediatric discharges from 3998 acute care hospitals, was analyzed for hospitalizations involving patients aged 19 and younger receiving ECT based on inpatient procedural codes.
315 (95% confidence interval 275 to 354) discharges among child and adolescent patients, or 0.03% of youth hospitalizations, involved the administration of ECT in the KID in 2019. Hospitalizations in the Northeast, those involving patients residing in ZIP codes in the top income quartile, and those for commercially insured patients had higher odds of ECT administration. Primary discharge diagnoses among ECT recipients were major depressive disorder (143; 46.4%), schizophrenia and other psychotic disorders (71; 23.1%) and bipolar disorder (59; 19.2%). In total 153 (48.6%) of ECT recipients had a coded diagnosis of suicidal ideation. Hospitalizations involved a median of 2 (IQR 1 to 5) ECT treatments before discharge.
ECT is rarely utilized in the inpatient treatment of child and adolescent patients, but is most often administered to patients with mood and psychotic disorders. Commercial insurance and higher income were associated with higher odds of ECT administration, suggesting that access to care may be limited.
电休克疗法（ECT）设备被归类为 II 类（中度风险），用于治疗 13 岁及以上患者的抑郁症和紧张症，但尚不清楚儿童和青少年患者的治疗频率。本研究旨在检查涉及 ECT 的儿童和青少年住院患者的人口统计学特征、这些住院患者的医疗和精神共病情况以及每次住院治疗的总次数。
分析了 2019 年儿童住院数据库，这是来自 3998 家急症护理医院的儿科出院患者的全国样本，根据住院程序代码，对 19 岁及以下接受 ECT 的患者的住院情况进行了分析。
2019 年，在 KID 中，315 名（95%置信区间 275 至 354）儿童和青少年患者或 0.03%的青年住院患者接受了 ECT 治疗。在东北地区、涉及居住在收入最高四分位数邮政编码的患者的住院治疗以及商业保险患者的住院治疗中，ECT 治疗的可能性更高。ECT 接受者的主要出院诊断为重度抑郁症（143；46.4%）、精神分裂症和其他精神病性障碍（71；23.1%）和双相情感障碍（59；19.2%）。共有 153 名（48.6%）ECT 接受者有自杀意念的编码诊断。住院治疗期间，平均有 2 次（IQR 1 至 5）ECT 治疗，然后出院。
ECT 在儿童和青少年患者的住院治疗中很少使用，但最常用于治疗情绪和精神病性障碍患者。商业保险和较高的收入与 ECT 治疗的可能性更高相关，这表明获得治疗的机会可能有限。
