Electroconvulsive therapy in children and adolescents: results from a population‑based study utilising the Swedish National Quality Register

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

BACKGROUND

For 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.

METHODS

In 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.

RESULTS

A 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.

CONCLUSIONS

ECT'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.

A new technology for pacifier weaning: a thematic analysis

Introduction

Babies and toddlers often become accustomed to using baby pacifiers. However, pacifiers may harm children's health and lead to various problems, such as less frequent breastfeeding, shorter breastfeeding duration, dental deformities, tooth decay, recurrent acute otitis media, sleep disorders, and the potential for accidents. This study aims to introduce new technology that may prevent babies from becoming used to a pacifier (patent titled "Prevents Getting Used to Pacifier Baby, Number SA10609, Saudi Authority for Intellectual Property"). This study used a descriptive qualitative design.

Methods

The participants included three pediatricians, three psychologists, three dentists, three family doctors, and three mothers of babies and toddlers, with a mean age of 42.6 years old (SD = 9.51). Semi-structured interviews were used, and thematic analysis was conducted to generate a thematic tree.

Results and Discussion

The thematic analysis resulted in three themes: (1) the disadvantages of pacifier use, (2) the introduction of new technology for the patent, and (3) the expectations for this technology. The results showed that a pacifier might negatively affect the health of babies and toddlers. However, the new technology may prevent children from becoming used to pacifiers and protect them from any possible physical or mental issues.