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When Can We Predict the Outcome of an Electroconvulsive Therapy Course in Adolescents?

A Retrospective Study

Maoz, Hagai MD*†; Nitzan, Uri MD*†; Goldwyn, Yiftach MA*; Krieger, Israel MD*†; Bloch, Yuval MD*†

doi: 10.1097/YCT.0000000000000469
Original Studies

Objective There is a dearth of up-to-date literature regarding electroconvulsive therapy (ECT) in adolescents, and the question of when to pronounce course failure has not been properly addressed. The current study aims to evaluate trajectories of clinical status throughout ECT courses in adolescent patients.

Methods We retrieved detailed data of 36 patients who received ECT in our treatment center. Clinical records were retrospectively assessed and evaluated every 6 ECT sessions to quantify Clinical Global Impressions-Improvement (CGI-I) scores.

Results The mean number of sessions per course was 24.4 ± 14.2. The mean CGI-I score at the conclusion of the ECT courses was 2.47 ± 1.19. At the end of the acute treatment stage, 26 patients (72.2%) were much or very much improved, based on CGI-I scores. Only 5 patients exhibited a significant response after 6 sessions or fewer, whereas 21 patients (56.6%) improved after 12 sessions. Pearson correlations between CGI-I scores throughout the course of ECT showed no significant correlation between CGI-I scores after 6 sessions and the final CGI-I scores. However, a significant correlation was found between CGI-I scores after 12 sessions and the final CGI-I score.

Conclusions An improvement in the clinical status of adolescents treated by ECT might occur only after a substantial number of sessions. An early lack of response does not necessarily predict a failed ECT course.

From the *Emotion-Cognition Research Center, Shalvata Mental Health Center, Hod-Hasharon; and

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Received for publication April 1, 2017; accepted August 30, 2017.

Reprints: Hagai Maoz, MD, The Emotion-Cognition Research Center, Shalvata Mental Health Center, 13 Aliyat-Hano'ar Street, Hod-Hasharon, 4510, Israel (e-mail:

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

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