title: Use of Electroconvulsive Therapy in Adolescents With Treatment-Resistant Depressive Disorders: A Case Series.
abstract: OBJECTIVE
  This study presents a comprehensive case series of adolescents who received electroconvulsive therapy (ECT) for treatment-resistant depression.
  
  
  METHODS
  Conducting a chart review, we identified 13 adolescents who had ECT for treatment of depression over a 5-year interval (2008-2013) at a Canadian tertiary care psychiatric hospital. Details about participants' clinical profile, index course of ECT, outcome, side effects, and comorbidities were extracted and analyzed.
  
  
  RESULTS
  Thirteen adolescents aged 15 to 18 years, received a mean of 14 (SD, 4.5) ECT sessions per patient. Based on the Beck Depression Inventory-II at baseline and after treatment with ECT, a reliable improvement was observed in 10 patients, with 3 achieving full recovery. Through mixed effects linear modeling, we found a decrease of 0.96 points (95% CI, -1.31 to -0.67, P < 0.001) on the Beck Depression Inventory-II total score for every ECT treatment received. The Montreal Cognitive Assessment was used for monitoring of cognitive function throughout the treatment. Adverse effects included transient subjective cognitive impairment (n = 11), headache (n = 10), muscular pain (n = 9), prolonged seizure (n = 3), and nausea and/or vomiting (n = 3).
  
  
  CONCLUSIONS
  A clinically significant improvement was observed for 10 (77%) adolescents receiving ECT for treatment-resistant depression. These observations suggest that ECT is a potential treatment option for refractory depression in selected adolescents. More data are needed to draw conclusions about efficacy and possible predictors of treatment response.
authors.affiliation: From the *Department of Psychiatry, University of Ottawa, Ottawa; †Youth Concurrent Disorders Inpatient Unit, Centre for Addiction and Mental Health; ‡Department of Psychiatry, University of Toronto, Toronto; §Youth Unit at the University of Ottawa Institute of Mental Health Research; and ∥Department of Psychiatry and Psychology, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Naista
authors.initials: N
authors.lastname: Zhand
authors.forename: Darren B
authors.initials: DB
authors.lastname: Courtney
authors.forename: Martine F
authors.initials: MF
authors.lastname: Flament
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000150:complications / Q000523:psychology; D003072:Cognition Disorders; D015897:Comorbidity; D061218:Depressive Disorder, Treatment-Resistant / Q000523:psychology / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D016896:Treatment Outcome