Electroconvulsive therapy as a treatment modality in adolescent psychiatric patients

Due to the relatively rare clinical application of electroconvulsive therapy (ECT) in adolescent psychiatric patients and its underrepresentation in the literature, the aim of this study was to explore indications for ECT in adolescents by systematically describing the clinical characteristics of patients treated at the Child and Adolescent Psychiatry Department, Aarhus University Hospital.

Data were extracted from the Business intelligence (BI) portal, comprising comprehensive electronic medical records. The study included 25 patients under the age of 21, who received ECT between 28 February 2020 and 28 February 2025. Treatment response was assessed using individual changes in the Manic Assessment Scale (MAS score), Brøset Violence Checklist (BVC-score), records of coercive measures, and psychiatric hospitalizations during a 200-day follow-up period.

Of the 25 patients, 12 were males (48%) with a mean age of 17 years. They were grouped by referral diagnosis: psychosis (n = 11), affective disorders (n = 11), and others (n = 3). Following ECT initiation, there was a marked and rapid reduction in both MAS and BVC scores. In addition, the use of coercive measures decreased by 74%. However, as patients received ECT in conjunction with pharmacological treatment adjustments, these observed changes should be interpreted as associations rather than causal effects of ECT alone.

ECT appears to be a safe and feasible intervention in child and adolescent psychiatry, associated with improvements in clinical outcomes within the context of concurrent pharmacotherapy. These findings support consideration of ECT earlier in the treatment trajectory for carefully selected, severely ill patients.