Electroconvulsive therapy for adolescents with severe depressive episode and suicidality: retrospective comparison between responders and non-responders

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

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

来源：CHILD AND ADOLESCENT PSYCHIATRY AND MENTAL HEALTH

ESI学科分类：PSYCHIATRY/PSYCHOLOGY

WOS号：WOS:001146266300004

JCR分区：Q1

影响因子：5.6

年份：2024

卷号：18

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Electroconvulsive therapy; Adolescent; Depression; Suicide; Retrospective study

摘要："BackgroundFor adolescents with major depression who exhibit suicidal tendencies, Electroconvulsive Therapy (ECT) is increasingly adopted in clinical practice. Yet, the precise mechanisms behind its effectiveness remain elusive, and studies on factors that influence treatment outcomes are scarce.MethodsIn this retrospective comparative study, we included all adolescent severe depressive episode patients with suicidal tendencies admitted to the Psychiatry Department of the First Affiliated Hospital of Chongqing Medical University between 2017 and 2021 and received ECT treatment. By collecting data on personal history, medical history, and standard treatment features, we established demographic, disease, medication, and ECT treatment factors variables. Patients were divided into effective and ineffective groups based on the Clinical Global Impressions-Improvement (CGI-I) scale scores, and differences between outcomes were compared. Logistic regression analyses were used to identify factors independently associated with ineffectiveness.ResultsA total of 494 adolescent severe depressive episode patients with suicidal behavior who received ECT were included in this study. According to CGI-I scores, the treatment was effective in 361 patients (73.1%) and ineffective in 133 patients (26.9%). Logistic regression analyses showed that 8 to 12 and 12 to 16 ECT sessions reduced the risk of ineffectiveness compared to fewer than 4 sessions. The risk of ineffectiveness decreased with age and increased with comorbidity with obsessive-compulsive disorder (OCD). Compared to sertraline, escitalopram was associated with a heightened risk of futility, whereas olanzapine and aripiprazole demonstrated a reduced risk when contrasted with quetiapine.ConclusionsECT's ineffectiveness in treating adolescent severe depressive episode with suicidal behavior decreases with age, and comorbidity with OCD significantly increases the risk of treatment failure. Fewer than 8 ECT sessions may hinder achieving satisfactory results."

基金机构：National Natural Science Foundation of China [81901373]

基金资助正文：This study was supported by the National Natural Science Foundation of China (grant/award number: 81901373).