Factors Affecting Use of Electroconvulsive Therapy in Adolescents in Texas and the US

Since 1938, electroconvulsive therapy (ECT) has been widely used in the treatment of catatonia, treatment-resistant depression, and severe mania. According to the American Academy of Child and Adolescent Psychiatry (AACAP), criteria1 for its use in youth is: 1) Presence of severe major depression or mania, schizoaffective disorder, schizophrenia, catatonia, and neuroleptic malignant syndrome. 2) Presence of severe, persistent, and disabling symptoms, such as refusal to eat or drink, severe suicidal ideation, uncontrollable mania, and psychosis. 3) Failure to respond to two adequate trials of medications. 4) ECT can also be used earlier when adequate medication trials cannot be administered because of failure to tolerate pharmacological treatment, or if the patient is incapacitated to the point that he/she is unable to take medication or awaiting a response to a medication poses a grave threat to life.