Electroconvulsive therapy in adolescents and adults with depression: Effects, cognitive function and related influencing factors.

BACKGROUND

Electroconvulsive therapy (ECT) is an effective and safe treatment for depression, but its efficacy and cognitive effects in adolescents remain unclear. This study compares the effects of a standardized ECT protocol on adolescent and adult depression patients and analyzes influencing factors.

METHODS

A total of 206 patients with major depressive disorder receiving combined antidepressant and ECT treatment were enrolled in this observational study. Depressive symptom severity and cognitive function were assessed by the HAMD and MoCA, respectively. Covariates were adjusted for using analysis of covariance.

RESULTS

A total of 130 adolescents and 76 adults were enrolled. After adjusting for covariates, the effective rate for adults was 86.5 %, significantly higher than the 65 % observed in adolescents (p < 0.01). Similarly, the remission rate for adults was 45.6 %, compared to 28.1 % in adolescents (p < 0.05). Regression analysis revealed that the number of hospitalizations (p < 0.01), baseline psychotic symptoms (p < 0.01), and MoCA cognitive-language scores (p < 0.05) were predictive factors for ECT efficacy in adolescent depression patients. Moreover, ECT was associated with improvements in attention, but declines were observed in overall cognitive function, language ability, and delayed memory. Additionally, after treatment of ECT, adolescent depression showed a significant improvement trend in MoCA naming function, whereas adult patients exhibited a significant deterioration (p < 0.05).

CONCLUSION

ECT was associated with alleviation of depressive symptoms and improvement in attention, but a trend of decline in overall cognitive function was also observed. Moreover, ECT appears more effective in adults than adolescents.