The efficacy of electroconvulsive therapy in adolescent major depressive disorder with suicidal ideation: A propensity score-matched, retrospective cohort study

作者全名：Wang, Xinglian; Ren, Hao; Zhang, Zheng; Zhong, Xiufen; Luo, Qinghua; Huang, Yan; Qiu, Haitang

作者地址：[Wang, Xinglian; Ren, Hao; Zhang, Zheng; Zhong, Xiufen; Luo, Qinghua; Qiu, Haitang] Chongqing Med Univ, Affiliated Hosp 1, Chongqing, Peoples R China; [Ren, Hao] Chongqing Changshou Dist Third Peoples Hosp, Chongqing, Peoples R China; [Zhong, Xiufen] Chongqing Mental Hlth Ctr, Chongqing, Peoples R China; [Huang, Yan] Chongqing Hosp Tradit Chinese Med, Chongqing, Peoples R China

通信作者：Qiu, HT (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Chongqing, Peoples R China.; Huang, Y (通讯作者)，Chongqing Hosp Tradit Chinese Med, Chongqing, Peoples R China.

来源：ASIAN JOURNAL OF PSYCHIATRY

ESI学科分类：PSYCHIATRY/PSYCHOLOGY

WOS号：WOS:001250960900001

JCR分区：Q1

影响因子：3.8

年份：2024

卷号：95

期号：　

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结束页：　

文献类型：Article

关键词：electroconvulsive therapy; medication; suicidal ideation; adolescents; efficacy

摘要：Background: More evidence is needed to validate the use of ECT in adolescent depression. This study aims to compare the effectiveness of electroconvulsive therapy (ECT) to conventional medication therapy for adolescents with major depression with suicidal ideation. Methods: In this retrospective cohort study, we reviewed inpatient records from the First Affiliated Hospital of Chongqing Medical University spanning December 2016 to June 2021. We focused on adolescents diagnosed with severe depression presenting with suicidal tendencies. To equalize baseline differences between patients, we used the one-to-one propensity score matching to match patients who received ECT treatment with those who did not. Multivariate regression analysis was utilized to adjust for potential confounders, and subgroup analyses and sensitivity analyses were conducted to verify the robustness of our findings. Results: Of the 626 patients in this study, 474 underwent ECT treatment while 152 received medication treatment, all aged between 10 and 18 years. Once matched, each group contained 143 patients. The ECT group demonstrated a significantly higher response rate and greater reductions in both Hamilton Depression Rating Scale and Hamilton Anxiety Scale scores (all P < 0.001). Additionally, the ECT group was more effective in reducing suicidal ideation, with fewer individuals retaining such ideation at discharge. In the multivariable regression analysis, both ECT treatment and shorter disease duration were independently linked to enhanced antidepressant efficacy. Subgroup analyses and sensitivity analyses verified the robustness of the main study effect. Conclusions: For adolescents with major depressive disorder and suicidal ideation, combining ECT with pharmacotherapy is more effective than pharmacotherapy alone before medications reach full effect.

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