Has the practice and outcome of ECT in adolescents changed? findings from a whole-population study.
OBJECTIVE
To investigate whether there were changes in the practice and outcome of electroconvulsive therapy (ECT) in adolescents in a whole population over a decade.


METHODS
All persons younger than 19 years who received ECT in the state of New South Wales, Australia, in the period from 1990 to 1999 were identified. Detailed information about diagnosis, treatment and outcome were then obtained.


RESULTS
Seventy-two patients aged 14-18 years underwent a total of 84 courses of ECT (1.53/100,000 adolescents were treated with ECT per year). In 1996 to 1999 compared with 1990 to 1995, there was an increase in ECT among females hospitalized involuntarily, EEG monitoring, stimulus dosing, bilateral ECT, and use of thiopentone. Overall, mood disorders derived most benefit from ECT while comorbid personality disorder predicted poorer short term outcome. Side effects were minor and transient.


CONCLUSIONS
The changes in ECT practice are consistent with changes in ECT practice generally over the survey period. The overall data on effectiveness and safety further support the treatment's use in young people.
Walter
Garry
G
Thomas Walker Hospital ("Rivendell"), Child and Adolescent Mental Health Services, Central Sydney Area Health Service and Department of Psychological Medicine, University of Sydney, Sydney, New South Wales, Australia. gwalter@mail.usyd.edu.au
Rey
Joseph M
JM
D000293:Adolescent; D000296:Adolescent Psychiatry / Q000639:trends*; D003866:Depressive Disorder / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000628:therapy*; D009517:New South Wales; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012307:Risk Factors; D016896:Treatment Outcome