Cognitive Side Effects of Electroconvulsive Therapy in Adolescents

Division of Child and Adolescent Psychiatry, University of Michigan, Ann Arbor 48109-0390, USA.
Journal of Child and Adolescent Psychopharmacology (Impact Factor: 2.93). 02/2000; 10(4):269-76. DOI: 10.1089/cap.2000.10.269
Source: PubMed


The primary aim of this study was to determine the presence of cognitive impairments among adolescents treated with electroconvulsive therapy (ECT) and whether these deficits would persist several months following the treatment.
Retrospective data resulting from standard clinical care of a convenience sample with naturalistic follow-up were used. Subjects were 16 adolescents (13 females, 3 males; mean age = 15.9 +/- 1.6 years) hospitalized with a mood disorder (unipolar depression = 14, bipolar depression = 2). Cognitive tests administered prior to ECT were compared with results at 7.0 +/- 10.3 days following the last treatment and with a second testing at 8.5 +/- 4.9 months after the last treatment.
Comparison of pre-ECT and the first post-ECT testing administered during the first 10 days of the treatment yielded significant impairments of concentration and attention, verbal- and visual-delayed recall, and verbal fluency. A complete recovery of these functions was noted at the second post-ECT testing. There was no deficit in the ability to problem solve during the initial or the subsequent testing.
Cognitive parameters found to be impaired during the first few days of ECT recovered over several months following the treatment. Therefore, there was no evidence of long-term damage to concentration, attention, verbal and visual memory, or verbal fluency. There were no impairments of motor strength and executive processing, even during the early (within 7-10 days) post-ECT period. These results should be regarded as preliminary, awaiting confirmation with larger samples.

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    • "The notion of ECT as a last resort treatment for children emerges most often alongside claims for its necessity in specific situations, i.e. for children with 'life-threatening illnesses' (Case and others, 2013; Cizaldo and Wheaton, 1995; Cohen and others, 2000; Esmaili and 208 Cheryl van Daalen-Smith et al. Malek, 2007; Ghaziuddin and others, 2000; Rabheru, 2001; and Wachtel and others, 2011) and for those children whose 'illness' has proven 'unresponsive' to medications (Bloch and others, 2001; Case and others, 2013; Cohen and others, 2000; Ghaziuddin and others, 2000; Kutcher and Robertson, 1995; Rey and Walter, 1997; Shoirah and Hamoda, 2011; Walter and others, 1997; Willoughby and others, 1997). With many distressed patients — both adults and children — experiencing a lack of improvement or increased distress with medication use (Whitaker, 2010), this presumably leaves many patients susceptible to 'last resort treatment'. "
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    ABSTRACT: This article examines the controversial and largely publicly undocumented practice of administering electroconvulsive therapy (ECT or electroshock) to children who are undergoing psychiatric treatment. Conventional psychiatric beliefs and practices are challenged, along with a presentation of the history of scientific research which questions electroshock's ‘effectiveness’ and outlines its brain-damaging and incapacitating effects. As such, we provide counterarguments regarding the legitimacy of ECT as a treatment option, deconstructing the principle of presumed prudence in its use. Our analysis leads us to conclude that the ‘principle of presumed prudence’ should be eschewed in favour of the ‘precautionary principle’, in order to underscore and uphold the medical ethos ‘to do no harm’ and to ensure the application of children's rights within the psychiatric system.
    Children &amp Society 05/2014; 28(3). DOI:10.1111/chso.12073 · 0.73 Impact Factor
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    • "Störungen der Gedächtnisfunktion bilden sich innerhalb von ein bis vier Wochen nach der EKT - Behandlungsserie zurück ( Ng et al . 2000 ) . Viele Untersuchungen beweisen , dass die eventuell auftretenden kognitiven Nebenwirkungen vollständig reversibel sind ( Rubin et al . 1993 ; Cohen et al . 2000 ; Ghaziuddin et al . 2000 ) ."
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    ABSTRACT: In der vorliegenden Studie sollte der Einfluss von Neuroleptika auf die Wirksamkeit und Verträglichkeit der Elektrokonvulsionstherapie bei schizophrenen Patienten untersucht werden. Dazu erfolgte eine retrospektive Analyse von 4803 EKT- Behandlungen, die in den Jahren 1995 bis 2002 an der Klinik für Psychiatrie und Psychotherapie der LMU durchgeführt wurden. Dabei sind sowohl allgemeine deskriptive Daten, insbesondere von depressiven Patienten und Patienten vom schizophrenen Formenkreis erfasst worden, als auch im Speziellen die EKT- Behandlungen mit begleitender neuroleptischer Medikation mit Elektrokonvulsionstherapien ohne neuroleptischer Begleitmedikation verglichen worden. Die Auswertung der Daten ergab eine gute Verträglichkeit der Elektrokonvulsionstherapie mit oder ohne neuroleptischer Begleitmedikation. Es zeigte sich, dass die Kombinationstherapie mit atypischen Neuroleptika einen positiven Behandlungseffekt hat. Insgesamt ist eine verbesserte antipsychotische Wirksamkeit der EKT bei Patienten mit affektiven Störungen im Vergleich zu schizophrenen Kranken festzustellen.
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    • "La eficacia descrita, todo y que varía según los diferentes estudios, es similar a la descrita en adultos, excepto para la depresión psicótica, donde se ha observado una eficacia menor y similar a la observada en la esquizofrenia, que podría atribuirse a la dificultad de discriminar entre ambas patologías en estas edades. En los estudios revisados (Domenech, 2004; Rey, 1997; Schneeckloth, 1993; Ghaziuddin 1996; Moise, 1996; Strober 1998; Duffet 1999; Ghaziuddin, 2000; Cohen, 2002; Etain, 2001) se describen los siguientes índices de eficacia: depresión mayor ( "
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