Journal Article Annotations
2023, 1st Quarter
Annotations by Liliya Gershengoren, MD
April, 2023
The finding:
This study demonstrated electroconvulsive therapy’s (ECT’s) efficacy and its effects on cognitive function in adolescents with major depressive disorder and suicidal ideation. Suicidal ideation and depressive symptoms decreased in patients receiving ECT relative to controls. Adverse cognitive effects of ECT gradually disappeared over time.
Strength and weaknesses:
The study had the advantage of enrolling only patients with depression and no other diseases, in contrast with prior studies, while also maintaining a sufficiently large sample size. It considered not just symptomatic improvement with ECT but also the adverse cognitive effects and their progress over time. However, the study measured only changes to cognitive function before and after ECT, but not during the treatment period.
Relevance:
Child and adolescent C-L psychiatrists may be asked to evaluate a hospitalized paediatric patient for symptoms of depression. Consideration of treatment involves a multifaceted approach and parents will often begin this conversation with the consulting psychiatrist. Symptoms severity including intensity of acute suicidal ideation with known intent and plan might prompt the C-L psychiatrists to discuss ECT as one of the treatment options in addition to medication management. While there remains much controversy around ECT in adolescents, it is important to begin the conversation with empirical evidence.