AN EPIDEMIOLOGIC-STUDY OF THE USE OF ECT IN ADOLESCENTS

Objective: There is little knowledge about the use of electroconvulsiv e therapy (ECT) in adolescents. Given the prevalence and severity of p sychiatric disorders in this age group, it is important to determine t he frequency, indications, effectiveness, and side effects of ECT. Met hod: Persons younger than 19 years who received ECT between 1990 and 1 996 in the Australian state of New South Wales were identified. Detail ed information about diagnosis, treatment, and outcome was then obtain ed. Results: Forty-two patients aged 14 to 18 years underwent a total of 49 courses comprising 450 ECTs (0.93% of all treatments given to al l persons). Marked improvement or resolution of symptoms occurred in h alf of the completed courses. Mood disorders derived most benefit from ECT. Side effects were transient and minor. Prolonged seizures were o bserved in 0.4% of treatments. Comorbid personality disorder predicted poorer response, and the anesthetic propofol was associated with shor ter seizures. Conclusions: Although ECT is an effective treatment for some mental disorders in adolescents and has few side effects, it is s eldom used. Indications, response, and unwanted effects were similar t o those observed in adults. The use of propofol may reduce the risk of prolonged seizures.