Outcomes of ECT in Adolescents with a Depressive Episode: LTE From China

 Out on PubMed, from authors in China, is this LTE:

Outcomes of electroconvulsive therapy in adolescents with a depressive episode (depressive, bipolar disorders): a naturalistic retrospective cohort study.

Zhu X, Wu Y, Chen X, Feng Z, Xu J, Zhang L, Chen X, Wang G.Brain Stimul. 2025 Jan 21:S1935-861X(25)00018-X. doi: 10.1016/j.brs.2025.01.016. Online ahead of print.PMID: 39848537


The LTE is here:

https://www.sciencedirect.com/science/article/pii/S1935861X2500018X?fr=RR-2&ref=pdf_download&rr=90722a2acba5bf8e

And from the text:


The main findings of this real-world retrospective study were as follows: ECT treatment is effective for adolescent patients experiencing a depressive episode. Factors influencing the response rate to ECTs include BMI, pretreatment severity of depression, presence of suicidality, and NSSI. Regarding the determination of the optimal number of ECTs, administering more than eight times appears to yield more favorable treatment outcome.

Normally, one would celebrate new information about ECT for severely depressed adolescents. Unfortunately, such a large cohort from China raises questions about psychiatric practice there. If we can take these data at face value they show good efficacy of ECT in this population. But I am not sure that the arcane statistics are necessary to show that 8 or treatments are optimal. Finally, one hopes this will be copy edited before final publication.


Comments

  1. In my opinion, the response rate is far beyond what we would expect in an adolescent cohort. On the other hand, the positive effect of depression severity and the negative effect of suicidal ideation makes sense. Would be interesting to further analyze the effect of comorbidities (PTSD, childhood maltreatment, ADHD, ...).

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