RESUMEN
OBJECTIVE: In order to improve our understanding of the use of electroconvulsive therapy (ECT) in adolescent patients, we aimed to evaluate the reasons for referral for ECT in different age groups. METHOD: We compared the reasons for adolescent and adult referrals by a retrospective file review of 13 consecutive adolescents and 56 consecutive adults treated in our ECT unit during a 5-year period. RESULTS: There was a significant association between age group and reason for referral. Non-response to pharmacotherapy was a significantly more common reason among adults. Adolescents were mainly referred due to catatonia and suicidal behaviour. CONCLUSION: Our results support the need to study reasons for referral to ECT, beyond non-response to pharmacotherapy, especially in adolescent patients.
Asunto(s)
Terapia Electroconvulsiva , Trastornos del Humor/terapia , Trastornos Psicóticos/terapia , Esquizofrenia/terapia , Adolescente , Adulto , Resistencia a Medicamentos , Análisis Factorial , Femenino , Humanos , Masculino , Trastornos del Humor/tratamiento farmacológico , Trastornos Psicóticos/tratamiento farmacológico , Estudios Retrospectivos , Esquizofrenia/tratamiento farmacológicoRESUMEN
BACKGROUND: There is a growing interest in gender differences of different psychiatric disorders, especially major depression. We sought a possible gender difference related to electroconvulsive therapy (ECT). METHODS: This retrospective study compared 20 male and 23 female depressed adult patients treated by ECT. We compared their findings on gender differences to those of 12 female and 4 male bipolar patients and 11 male and 19 female schizophrenic patients, all treated in the same ECT setting. RESULTS: Depressed female patients underwent significantly fewer antidepressant drug trials than males before being referred to ECT (t41=2.09, P<0.05). A similar gender difference was found in the treatment of patients suffering from schizophrenia: female patients underwent fewer pharmacological antipsychotic trials than males before being referred to ECT (t28=3.11, P<0.01). ECT was significantly more effective in female patients than in male patients suffering from schizophrenia (U=38, P<0.05). LIMITATIONS: This is a retrospective pilot study whose results are based on subjective evaluations. CONCLUSION: The findings of this study may support a gender difference both in referral and in the outcome of ECT. CLINICAL RELEVANCE: there might be a need to consider lowering the number of pre-ECT drug trials for depressed males and to consider ECT as a viable therapeutic option for schizophrenic females.