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

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.