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Common Use of Electroconvulsive Therapy for Chinese Adolescent Psychiatric Patients

Zhang, Qing-E MD; Wang, Zhi-Min MD; Sha, Sha MD; Ng, Chee H. MD; Seiner, Stephen J. MD; Welch, Charles A. MD; Lok, Grace K.I. MNs, MEd; Chow, Ines H.I. MSc; Wang, Fei MD; Li, Lu MSc; Xiang, Yu-Tao MD, PhD

doi: 10.1097/YCT.0000000000000327
Original Studies

Purpose Little is known about the use of electroconvulsive therapy (ECT) for adolescent psychiatric patients in China. This study examined the frequency of ECT and the demographic and clinical correlates of adolescent psychiatric patients hospitalized in a tertiary psychiatric hospital in China.

Methods This was a retrospective chart review of 954 inpatients aged between 13 and 17 years treated over a period of 8 years (2007–2013). Sociodemographic and clinical data were collected from the electronic chart management system for discharged patients.

Results The rate of ECT use was 42.6% in the whole sample (46.5% for patients with schizophrenia, 41.8% for major depressive disorder, 57.8% for bipolar disorders, and 23.9% for other diagnoses). Use of ECT was independently and positively associated with older age, high aggression risk at time of admission, and use of antipsychotics and antidepressants. Compared with patients with schizophrenia, those with other psychiatric diagnoses were less likely to receive ECT. The above significant correlates explained 32% of the variance of ECT use (P < 0.001). Limitations of this study included the lack of data regarding the efficacy and side effects of ECT. Furthermore, the high rate of ECT applied only to 1 setting which limits the ability to extrapolate the implications of the results to other populations.

Conclusions The use of ECT was exceedingly high in adolescent patients treated in a tertiary clinical centre in China. It is unlikely that such a high rate of ECT use is found across China or that such practice reflects standard of care for psychiatrically ill adolescents. The underlying reasons for the high use of ECT at this center warrant urgent investigations.

From the *The National Clinical Research Center for Mental Disorders, China & Mood Disorders Centre, Beijing Anding Hospital, Capital Medical University, Beijing, China; †Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia; ‡Electroconvulsive Therapy Service, McLean Hospital, Belmont; §Harvard Medical School, Department of Psychiatry, Boston, MA; ∥Department of Education, Kiang Wu Nursing College of Macau; ¶Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.

Received for publication November 16, 2015; accepted February 29, 2016.

Q.-E.Z., Z.-M.W., and S.S. contributed equally to the article.

Reprints: Yu-Tao Xiang, Faculty of Health Sciences, University of Macau, 3/F, Building E12, Avenida da Universidade, Taipa, Macau SAR, China (e-mail:

The authors have no conflicts of interest or financial disclosures to report.

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