ECT For Children and Adolescents in Europe: New Review From Germany

Out on PubMed, from colleagues in Germany, is this review:

Electroconvulsive therapy in children and adolescents in Europe-a systematic review of the literature complemented by expert information and guideline recommendations.

Licht C, Weirich S, Reis O, Kölch M, Grözinger M.Eur Child Adolesc Psychiatry. 2023 Jul 17. doi: 10.1007/s00787-023-02248-y. Online ahead of print.PMID: 37458849 Review.

The abstract is copied below:

The first documented pediatric use of Electroconvulsive therapy (ECT) occurred in Europe in 1941. Since then, predominantly successful treatments and reasonable side effects have been reported in severely ill minors. Nevertheless, a shy reluctance determines the controversy about ECT in young patients. This study describes the use of ECT in children and adolescents in Europe. We systematically searched the literature concerning the practice of ECT in minors in all 53 European countries. In addition, we surveyed European experts about national practices and compared guidelines for ECT in minors. The search yielded 79 publications from 18 European countries, mainly from Western Europe, Israel, and Turkey. National data were available from eight countries. These showed an interestingly high relationship between the number of minors treated with ECT and the general use of ECT. No persistent deficits or deaths were reported. On the other hand, no randomized clinical trial was found, and many publications lacked relevant information. Accordingly, the appraisal of the evidence in the guidelines varies considerably. Experts from 13 European countries consistently reported infrequent and unsystematic use of ECT in minors. ECT has been used successfully in minors in Europe with reasonable complications and side effects. Adverse effects on the developing brain, as often suspected, have not been scientifically supported in eight decades. Nevertheless, the use of ECT in Europe is sparse and dependent on accidental circumstances. High-quality evidence is needed, as well as improved knowledge and training of child and adolescent psychiatrists.

Keywords: Aversion; Developing brain; Electroconvulsive therapy; European countries; Expert information; Minors; Pediatric; Therapy-resistant.

The article is here.

And from the text:

This is an excellent review of the state of ECT for children and adolescents in Europe. It should, however, be of interest to ECT psychiatrists all around the world.

The findings of low use and reluctance to prescribe are not surprising, and deserving of ongoing corrective efforts by the field.

Big kudos to these authors for this impressive and informative piece of work!