ArticleBMC psychiatry2026
Psychiatric, anesthetic, and procedural characteristics of modified electroconvulsive therapy courses in adolescents treated in a tertiary child and adolescent psychiatry service: a 15-year retrospective cohort study.
Article in BMC psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEvidence on electroconvulsive therapy (ECT) in adolescents is largely retrospective and rarely reports psychiatric outcomes together with anesthetic and procedural characteristics. We characterized modified ECT courses in a tertiary child and adolescent psychiatry service.
methodsThis retrospective cohort included adolescents aged 13-18 years treated with modified ECT from 2010 to 2025; the ECT course was the unit of analysis. Illness severity was rated with the Clinical Global Impression-Severity (CGI-S) scale at admission and discharge. The primary outcome was a composite of any documented hemodynamic event, prolonged seizure, or recovery/behavioral event; short or absent seizures were analyzed separately as a technical seizure-adequacy outcome. Logistic models used standard errors clustered by patient.
resultsAmong 156 ECT courses in 150 adolescents (1,465 sessions), diagnoses were schizophrenia spectrum (46.2%), bipolar spectrum (23.1%), neurodevelopmental (18.6%), and depressive disorders (12.2%). Median CGI-S decreased from 5.0 at admission to 3.0 at discharge, with a study-defined decrease of at least 2 points in 152 courses (97.4%) and a discharge CGI-S of 2 or less in 60 (38.5%). The primary composite event occurred in 63 courses (40.4%), involving one event domain in 49 (31.4%) and two or more in 14 (9.0%). Short or absent seizures occurred in 42 courses (26.9%); theophylline use was associated with higher odds of this outcome, most plausibly reflecting confounding by indication. Estimates for age, bipolar spectrum disorder, and succinylcholine dose were imprecise and hypothesis-generating.
conclusionsIn this severe tertiary cohort, ECT-centered inpatient care was associated with substantial within-course global improvement, and acute course-level events were common but usually confined to a single domain. Acute anesthesia- or procedure-related events and technical seizure adequacy should be reported separately, and exploratory dose or medication associations should not be interpreted causally.
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