1
|
Xiao H, Meng Y, Liu S, Cao Y, Sun H, Deng G, Wang M, Zheng Y, Qiu C. Non-invasive brain stimulation for treating catatonia: a systematic review. Front Psychiatry 2023; 14:1135583. [PMID: 37260758 PMCID: PMC10227525 DOI: 10.3389/fpsyt.2023.1135583] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 04/12/2023] [Indexed: 06/02/2023] Open
Abstract
Background Non-invasive brain stimulation (NIBS) techniques offer new therapeutic options for modifying pathological neuroplasticity and have been proven to be beneficial in the treatment of neuropsychiatric disorders. Objective This study aimed to investigate the role of NIBS in treating catatonia. Materials and methods We conducted a systematic search to identify meta-analyses or systematic reviews on electroconvulsive therapy (ECT) and studies on the effects of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) on patients with catatonia from the PubMed, Web of Science, Embase, China National Knowledge Internet, Wanfang, and China Science and Technology Journal databases from inception until 31 July 2022. The methodological quality of the included studies was assessed with the AMSTAR2 or Joanna Briggs Institute Critical Appraisal tools. Paired t-tests and Wilcoxon signed-rank tests were used to compare changes in catatonia symptom scores after rTMS or tDCS. Results A total of 13 systematic reviews and one meta-analysis on ECT, two systematic reviews and 12 case reports on rTMS, and seven studies of 14 cases applying tDCS were identified. Systematic reviews of ECT consistently described improvement in catatonia symptoms across catatonia types and patient age groups. After treatment with rTMS (t = 4.489, p = 0.006) and tDCS (z = -3.065, p = 0.002), patients exhibited significant improvement. Conclusion ECT, rTMS, and tDCS were effective in treating catatonia. Early intervention with NIBS techniques may help improve catatonia symptoms in patients with schizophrenia. It may be advantageous to use rTMS or tDCS to maintain this improvement. NIBS techniques may thus represent a promising treatment for catatonia, but additional high-quality randomized controlled trials are needed.
Collapse
Affiliation(s)
- Hongqi Xiao
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Yajing Meng
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Shiyu Liu
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Yuan Cao
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Huan Sun
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Gaoju Deng
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Mei Wang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Yaozong Zheng
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Changjian Qiu
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| |
Collapse
|
2
|
Patel RS, Hobart K, Wadhawan A, Chalia A, Youssef NA. Electroconvulsive Treatment Utilization for Inpatient Management of Catatonia in Adolescents With Schizophrenia Spectrum Disorders. J ECT 2022; 38:244-248. [PMID: 35623014 DOI: 10.1097/yct.0000000000000858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to determine rates of electroconvulsive therapy (ECT) use for catatonia in schizophrenia spectrum disorders, stratified by patient demographics and hospital characteristics, and its impact on inpatient length of stay and cost. METHODS We found 155 adolescents (aged 12-18 years) with principal discharge diagnosis of schizophrenia spectrum disorders with catatonia from the National Inpatient Sample. They were subgrouped into ECT (n = 20) and non-ECT (n = 135) groups. We used descriptive statistics to evaluate the utilization of ECT for catatonia and independent-sample t test for continuous variables with statistical significance at P ≤ 0.05. RESULTS The overall utilization rate of ECT in adolescents for catatonia was 12.9%. A high rate of ECT use was evident for Whites (30.8%) compared with the other race/ethnicities and also was seen in private health insurance beneficiaries (20%). The rate of ECT use varied by the region, with highest for the Northeast (20%), followed by the South (18.2%), and the West (14.3%). Adolescent inpatients with catatonia in public and teaching type, and large bed-size hospitals were more likely to receive ECT than their counterparts. The mean number of ECT sessions required during the inpatient stay was 5.2 (range, 1-15), and the mean number of days from admission to initial ECT was 2.5 (range, 0-6). CONCLUSIONS Electroconvulsive therapy is used for approximately only 13% of adolescents with catatonia when comorbid schizophrenia spectrum disorders are present, suggesting that many patients may not get evidence-based treatment. Future studies in this area are needed.
Collapse
Affiliation(s)
- Rikinkumar S Patel
- From the Department of Psychiatry, Oklahoma State University, Norman, OK
| | - Kelsey Hobart
- Department of Psychiatry, Saint Elizabeths Hospital, Washington, DC
| | | | - Ankit Chalia
- Department of Psychiatry, West Virginia University, Martinsburg, WV
| | - Nagy A Youssef
- Department of Psychiatry, The Ohio State University College of Medicine, Columbus, OH
| |
Collapse
|
3
|
Døssing E, Pagsberg AK. Electroconvulsive Therapy in Children and Adolescents: A Systematic Review of Current Literature and Guidelines. J ECT 2021; 37:158-170. [PMID: 34424874 DOI: 10.1097/yct.0000000000000761] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
ABSTRACT There is a lack of studies regarding the efficacy of electroconvulsive therapy (ECT) in children and adolescents. In this study, we aimed to assess benefits and harms of ECT in children and adolescents with major psychiatric diseases. We conducted a systematic search in PubMed, EMBASE, and PsycINFO for peer-reviewed articles written in English regarding the use of ECT as treatment for major psychiatric diseases in children and adolescents. This study consists of 192 articles, mostly case studies (n = 50), reviews and overview articles (n = 52), and retrospective studies (n = 30). We present an overview of evidence for ECT in children and adolescents with mood disorders, catatonia, schizophrenia, intellectual disability, self-injurious behavior, and other indications. This article is also a summary of international guidelines regarding the use of ECT in children and adolescents. We evaluated the overall quality of evidence by using Grading of Recommendations, Assessment, Development and Evaluations and found the overall level of evidence to be of low quality. There are no absolute contra indications for ECT in children and adolescents. Fears regarding cognitive dysfunction have not been reproduced in studies. Electroconvulsive therapy should be considered in severe, treatment-resistant mood disorders, catatonia, and schizophrenia, especially in older adolescents. High-quality studies are warranted to assess the efficacy of ECT, especially in these potentially life-threatening diseases.
Collapse
Affiliation(s)
- Erik Døssing
- From the Child and Adolescent Mental Health Centre, Mental Health Services, Zealand Region, Roskilde
| | | |
Collapse
|
4
|
Hořínková J, Bartečků E, Kališová L. The Practice of Electroconvulsive Therapy in Children and Adolescents in the Czech Republic. J ECT 2021; 37:112-118. [PMID: 33093400 DOI: 10.1097/yct.0000000000000726] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The aim of this study was to describe the practice of electroconvulsive therapy (ECT) in child and adolescent patients in the Czech Republic. METHODS We conducted a mail questionnaire survey among Czech facilities associated with the Association of Child and Adolescent Psychiatry, and university hospitals with inpatient psychiatric wards, focused on the practice of ECT between 2013 and 2017 in patients younger than 18 years. RESULTS Of 18 approached facilities, 13 had access to ECT, and only 6 used ECT on 16 patients. The most common diagnosis was schizophrenia or related disorders (68.75% of patients), and the most common reason for ECT was catatonic symptoms (37.5%). The most common ECT methodology was bitemporal electrode placement with brief-pulse current (62.5%). In 2 patients, ECT was terminated because of ineffectiveness and in 1 patient because of adverse reaction. In other patients, ECT ended after achieving a clinical effect. The most common adverse effect was transient memory impairment in a quarter of the patients. The number of pharmacological treatment attempts before ECT significantly correlated with hospitalization length. CONCLUSIONS The utilization of ECT among children and adolescents was low. It was usually used in severe conditions after several pharmacological treatment attempts, which may indicate reluctance among providers to use this modality. A number of pharmacological attempts were associated with longer hospitalizations. In the majority of patients, ECT was effective and safe. On the other hand, the monitoring of cognitive adverse effects was insufficient and could be improved.
Collapse
Affiliation(s)
- Jana Hořínková
- From the Department of Psychiatry, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno
| | - Elis Bartečků
- From the Department of Psychiatry, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno
| | - Lucie Kališová
- Department of Psychiatry, First Faculty of Medicine, Charles University in Prague, and General University Hospital in Prague, Prague, Czech Republic
| |
Collapse
|
5
|
Maley CT, Becker JE, Shultz EKB. Electroconvulsive Therapy and Other Neuromodulation Techniques for the Treatment of Psychosis. Child Adolesc Psychiatr Clin N Am 2019; 28:91-100. [PMID: 30389079 DOI: 10.1016/j.chc.2018.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Electroconvulsive therapy is an established treatment for symptoms of psychosis and is currently recommended for use in patients who are experiencing an acute exacerbation of positive symptoms or who have had catatonia. There is also evidence to suggest that electroconvulsive therapy can be a safe, effective treatment in first episode psychosis, such as schizophrenia spectrum disorders, particularly in treatment-resistant patients. Other forms of neuromodulation (transcranial magnetic stimulation, transcranial direct current stimulation, vagus nerve stimulation, deep brain stimulation) have less of an evidence base to support their use and are not formally indicated for the treatment of psychosis.
Collapse
Affiliation(s)
- Christopher Todd Maley
- Department of Psychiatry, Vanderbilt University Medical Center, Vanderbilt Psychiatric Hospital, 1601 23rd Avenue South, Nashville, TN 37212, USA.
| | - Jonathan Essary Becker
- Department of Psychiatry, Vanderbilt University Medical Center, Vanderbilt Psychiatric Hospital, 1601 23rd Avenue South, Nashville, TN 37212, USA
| | - Elizabeth K B Shultz
- Department of Psychiatry, Vanderbilt University Medical Center, Vanderbilt Psychiatric Hospital, 1601 23rd Avenue South, Nashville, TN 37212, USA
| |
Collapse
|
6
|
Experience, Knowledge, and Attitudes of Child and Adolescent Psychiatrists in Belgium Toward Pediatric Electroconvulsive Therapy. J ECT 2018; 34:247-252. [PMID: 29465501 DOI: 10.1097/yct.0000000000000489] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of the present study was to ascertain the experience, knowledge, and attitudes of child and adolescent psychiatrists toward the use of ECT (electroconvulsive therapy) in children and adolescents in Belgium. METHODS A questionnaire was mailed to all the members of the Flemish and Walloon Association of Child and Adolescent Psychiatrists. RESULTS Thirty-five percent (n = 151) of the psychiatrists responded to the questionnaire. Sixty-seven percent (n = 101) rated their knowledge about ECT in children and adolescents as nil or negligible. Only one percent (n = 2) estimated their knowledge to be advanced. Fifteen percent (n = 22) were aware of a minor treated with ECT. Ten (n = 16) and thirty-one percent (n = 47) believed that ECT is a safe treatment for children and adolescents, respectively. Only six percent (n = 10) would recommend ECT for a major psychiatric disorder in a child, whereas thirty-eight percent (n = 58) for an adolescent. Fifty-three percent (n = 71) regarded ECT as a treatment of last resort. A significant correlation was identified between knowledge and attitudes toward the use of ECT in minors. Respondents with some or advanced knowledge perceived ECT as a safer and a more effective treatment option than those with negligible knowledge. Most (91%, n = 138) of the child and adolescent psychiatrists are enthusiastic to learn more about the use of ECT in minors. CONCLUSIONS Flemish and Walloon child and adolescents psychiatrists have very little experience with using ECT in minors. They self-estimated their knowledge as negligible but are keen to learn more about this treatment option. The lack of knowledge likely explains the rare use of ECT in Belgium for children and adolescents with serious psychiatric disorders.
Collapse
|
7
|
Leroy A, Naudet F, Vaiva G, Francis A, Thomas P, Amad A. Is electroconvulsive therapy an evidence-based treatment for catatonia? A systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci 2018; 268:675-687. [PMID: 28639007 DOI: 10.1007/s00406-017-0819-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 06/06/2017] [Indexed: 12/13/2022]
Abstract
We aimed to review and discuss the evidence-based arguments for the efficacy of electroconvulsive therapy (ECT) in the treatment of catatonia. Randomized controlled trials (RCTs) and observational studies focusing on the response to ECT in catatonia were selected in PubMed, the Cochrane Library, Embase, ClinicalTrials.gov and Current Controlled Trials through October 2016 and qualitatively described. Trials assessing pre-post differences using a catatonia or clinical improvement rating scale were pooled together using a random effect model. Secondary outcomes were adverse effects of anesthesia and seizure. 564 patients from 28 studies were included. RCTs were of low quality and were heterogeneous; therefore, it was not possible to combine their efficacy results. An improvement of catatonic symptoms after ECT treatment was evidenced in ten studies (SMD = -3.14, 95% CI [-3.95; -2.34]). The adverse effects that were reported in seven studies included mental confusion, memory loss, headache, or adverse effects associated with anesthesia. ECT protocols were heterogeneous. The literature consistently describes improvement in catatonic symptoms after ECT. However, the published studies fail to demonstrate efficacy and effectiveness. It is now crucial to design and perform a quality RCT to robustly validate the use of ECT in catatonia.Prospero registration information: PROSPERO 2016: CRD42016041660.
Collapse
Affiliation(s)
- Arnaud Leroy
- CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Department of Psychiatry, Univ. Lille, F-59000, Lille, France.
| | - Florian Naudet
- INSERM Centre d'Investigation Clinique 1414, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Guillaume Vaiva
- CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Department of Psychiatry, Univ. Lille, F-59000, Lille, France
| | - Andrew Francis
- Department of Psychiatry, Penn State Medical School, Hershey, PA, USA
| | - Pierre Thomas
- CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Department of Psychiatry, Univ. Lille, F-59000, Lille, France
| | - Ali Amad
- CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Department of Psychiatry, Univ. Lille, F-59000, Lille, France
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| |
Collapse
|
8
|
Grover S, Varadharajan N, Avasthi A. A qualitative study of experience of parents of adolescents who received ECT. Asian J Psychiatr 2017; 30:109-113. [PMID: 28869922 DOI: 10.1016/j.ajp.2017.08.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 08/10/2017] [Accepted: 08/28/2017] [Indexed: 11/26/2022]
Abstract
AIM OF THIS STUDY To evaluate the experience of parents of adolescents who received ECT for severe mental illness. METHODOLOGY Using qualitative methods, 6 parents of 5 adolescents were interviewed by using a self-designed semi-structured interview after the completion of ECT course. The clinicians involved in the ECT procedure, i.e., seeking informed consent and administration of ECT were not aware about the study. All the interviews were recorded and the content was analysed and themes were generated. RESULTS Parents of all the 5 adolescents expressed that their children were considered for ECT only after the patient had not responded to medication and were unmanageable. Prior to ECT the treating doctors did explain to them about the ECT procedure, they were given information booklet and they were not coerced to consent for ECT. Some of the parents reported that they had dilemma prior to giving consent and were scared prior to the first ECT. However, as the clinical condition of their children improved, they felt that ECT was a good treatment. Majority of the parents felt that ECT was delayed for their children. When asked about restriction in use of ECT in children and adolescents, the parents expressed that it is important for law makers to understand the distress of the parents,when their children are acutely ill. They expressed that decision of administration of ECT must be left to the family and the treating clinicians. CONCLUSION Parents of adolescents considered for ECT are generally satisfied with the treatment procedure.
Collapse
Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - Natarajan Varadharajan
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Ajit Avasthi
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| |
Collapse
|
9
|
Borgohain L, Chaudhury D, Mollah MI, Paul S. ELECTROCONVULSIVE THERAPY AMONG ADOLESCENT PSYCHIATRIC PATIENTS- A RETROSPECTIVE STUDY. JOURNAL OF EVIDENCE BASED MEDICINE AND HEALTHCARE 2017; 4:2519-2525. [DOI: 10.18410/jebmh/2017/499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2023]
|
10
|
Flamarique I, Baeza I, de la Serna E, Pons A, Bernardo M, Castro-Fornieles J. Thinking About Electroconvulsive Therapy: The Opinions of Parents of Adolescents with Schizophrenia Spectrum Disorders. J Child Adolesc Psychopharmacol 2017; 27:75-82. [PMID: 26983067 DOI: 10.1089/cap.2015.0196] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To assess the experience with, knowledge of, and attitudes toward electroconvulsive therapy (ECT) among parents of adolescents with schizophrenia spectrum disorders (SSD) who have received ECT. METHODS A self-administered questionnaire was used to assess the experience with, knowledge of, and attitudes toward ECT in a sample of parents of adolescents diagnosed with SSD. Parents of adolescents treated with ECT before the age of 18 years (ECT group; n = 19) were compared with a randomly selected group of parents of adolescents treated only with antipsychotics (No ECT group; n = 20). RESULTS Most parents in the ECT group claimed that they had received adequate information about the ECT procedure (94.7%), most of them thought it had been helpful for their children (73.7%) and none thought that it had made things worse. The large majority of parents in the ECT group (80%) thought that the illness had been worse than ECT or medication, and none thought that ECT was the worst. Parents in the ECT group generally had better knowledge of what ECT is and its indications. All the parents in the ECT group (100%) and almost all of those in the No ECT group (94.7%) would agree to the treatment for their children if recommended in the future by a doctor, there being no differences between the groups in this respect (p = 0.447). Most parents in the ECT group (88.9%) thought it was a legitimate treatment when used appropriately, an opinion that was held by a much smaller proportion of parents in the No ECT group (52.6%), although the remaining parents in that group were unsure about it (47.4%). CONCLUSIONS Most parents of adolescents with SSD treated with ECT had positive views about the treatment. Parents of adolescents treated only with antipsychotics tended either to have positive views about ECT or claimed to have no knowledge about it, with negative views being uncommon.
Collapse
Affiliation(s)
- Itziar Flamarique
- 1 Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic of Barcelona , Barcelona, Spain .,2 Centro de Investigación Biomédica en Red de Salud Mental , CIBERSAM, Barcelona, Spain
| | - Inmaculada Baeza
- 1 Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic of Barcelona , Barcelona, Spain .,2 Centro de Investigación Biomédica en Red de Salud Mental , CIBERSAM, Barcelona, Spain .,3 Institut d'Investigació Biomèdica August Pi i Sunyer , IDIBAPS, Barcelona, Spain
| | - Elena de la Serna
- 1 Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic of Barcelona , Barcelona, Spain .,2 Centro de Investigación Biomédica en Red de Salud Mental , CIBERSAM, Barcelona, Spain
| | - Alexandre Pons
- 2 Centro de Investigación Biomédica en Red de Salud Mental , CIBERSAM, Barcelona, Spain .,4 Barcelona Clinic Schizophrenia Unit, Department of Psychiatry and Psychology, Institut Clínic de Neurociències, Hospital Clínic of Barcelona , Barcelona, Spain
| | - Miguel Bernardo
- 2 Centro de Investigación Biomédica en Red de Salud Mental , CIBERSAM, Barcelona, Spain .,3 Institut d'Investigació Biomèdica August Pi i Sunyer , IDIBAPS, Barcelona, Spain .,4 Barcelona Clinic Schizophrenia Unit, Department of Psychiatry and Psychology, Institut Clínic de Neurociències, Hospital Clínic of Barcelona , Barcelona, Spain .,5 Department of Psychiatry and Clinical Psychology, University of Barcelona , Barcelona, Spain
| | - Josefina Castro-Fornieles
- 1 Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic of Barcelona , Barcelona, Spain .,2 Centro de Investigación Biomédica en Red de Salud Mental , CIBERSAM, Barcelona, Spain .,3 Institut d'Investigació Biomèdica August Pi i Sunyer , IDIBAPS, Barcelona, Spain .,5 Department of Psychiatry and Clinical Psychology, University of Barcelona , Barcelona, Spain
| |
Collapse
|
11
|
Flamarique I, Castro-Fornieles J, de la Serna E, Pons A, Bernardo M, Baeza I. Patients' Opinions About Electroconvulsive Therapy: What Do Adolescents with Schizophrenia Spectrum Disorders Think? J Child Adolesc Psychopharmacol 2015; 25:641-8. [PMID: 26447644 DOI: 10.1089/cap.2015.0113] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The purpose of this study was to assess, in patients with schizophrenia spectrum disorders (SSD) who received electroconvulsive therapy (ECT) prior to the age of 18, their experience, knowledge, and attitudes toward ECT, and to compare the findings with those obtained in adolescents treated only with antipsychotics. METHODS Patients diagnosed with SSD (n = 19) and treated with ECT before the age of 18 years (ECT group; n = 19) were compared with a randomly selected group of patients with SSD treated only with antipsychotics (non-ECT group, n = 21). A self-administered questionnaire was used to assess their experience, knowledge, and attitudes. RESULTS Most adolescents in the ECT group thought that the intervention had been helpful (78.9%) and believed that their illness had been worse than ECT or medication (68.4%). Similarly, almost three quarters of these patients did not believe the treatment to be cruel (73.7%) or outdated (73.7%), or that it should be illegal (68.4%). Patients in the non-ECT group often chose "don't know" as their response to the survey questions, and significant differences between the groups were observed. Most patients in both the ECT group (84.2%) and the non-ECT group (80%) said that they would accept the treatment in the future if necessary, there being no differences between the groups in this respect (p = 0.2). CONCLUSIONS Most adolescents in the ECT group had positive views about ECT. By contrast, most adolescents in the non-ECT group either did not know or did not have a clear opinion regarding ECT treatment, although they did not have negative views about it.
Collapse
Affiliation(s)
- Itziar Flamarique
- 1 Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic of Barcelona , Spain .,2 Centro de Investigación Biomédica en Red de Salud Mental , Barcelona, Spain
| | - Josefina Castro-Fornieles
- 1 Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic of Barcelona , Spain .,2 Centro de Investigación Biomédica en Red de Salud Mental , Barcelona, Spain .,3 Institut d'Investigació Biomèdica August Pi i Sunyer , Barcelona, Spain .,4 Department of Psychiatry and Clinical Psychology, University of Barcelona , Spain
| | - Elena de la Serna
- 1 Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic of Barcelona , Spain .,2 Centro de Investigación Biomédica en Red de Salud Mental , Barcelona, Spain
| | - Alexandre Pons
- 2 Centro de Investigación Biomédica en Red de Salud Mental , Barcelona, Spain .,5 Barcelona Clinic Schizophrenia Unit, Department of Psychiatry and Psychology, Institut Clínic de Neurociències, Hospital Clínic of Barcelona , Spain
| | - Miguel Bernardo
- 2 Centro de Investigación Biomédica en Red de Salud Mental , Barcelona, Spain .,3 Institut d'Investigació Biomèdica August Pi i Sunyer , Barcelona, Spain .,4 Department of Psychiatry and Clinical Psychology, University of Barcelona , Spain .,5 Barcelona Clinic Schizophrenia Unit, Department of Psychiatry and Psychology, Institut Clínic de Neurociències, Hospital Clínic of Barcelona , Spain
| | - Inmaculada Baeza
- 1 Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic of Barcelona , Spain .,2 Centro de Investigación Biomédica en Red de Salud Mental , Barcelona, Spain .,3 Institut d'Investigació Biomèdica August Pi i Sunyer , Barcelona, Spain
| |
Collapse
|