Abstract
Efficacious intervention for severe, treatment-refractory self-injurious behavior and aggression (SIB/AGG) in children and
adolescents with intellectual disability and concomitant psychiatric disorders remains a complex and urgent issue. The aim
of this study is to assess the efficacy of electroconvulsive therapy (ECT) on severe and treatment-resistant SIB/AGG in young
people with intellectual disability and current psychiatric disorder. We reviewed the charts of all patients (N = 4) who received ECT in the context of SIB/AGG with resistance to behavioral interventions, milieu therapy and pharmacotherapy
from 2007 to 2011. We scored the daily rate of SIB/AGG per patient for each hospital day. Inter rater reliability was good
(intraclass correlations = 0.91). We used a mixed generalized linear model to assess whether the following explanatory variables
(time, ECT) influenced the course of SIB/AGG over time, the dependant variable. The sample included two girls and two boys.
The mean age at admission was 13.8 years old [range 12–14]. The patients had on average 19 ECT sessions [range 16–26] and
one patient received maintenance ECT. There was no effect of time before and after ECT start. ECT was associated with a significant
decrease in SIB/AGG scores (p < 0.001): mean aggression score post-ECT was half the pre-ECT value. ECT appears beneficial in severe, treatment-resistant
SHBA in adolescents with intellectual disability.
adolescents with intellectual disability and concomitant psychiatric disorders remains a complex and urgent issue. The aim
of this study is to assess the efficacy of electroconvulsive therapy (ECT) on severe and treatment-resistant SIB/AGG in young
people with intellectual disability and current psychiatric disorder. We reviewed the charts of all patients (N = 4) who received ECT in the context of SIB/AGG with resistance to behavioral interventions, milieu therapy and pharmacotherapy
from 2007 to 2011. We scored the daily rate of SIB/AGG per patient for each hospital day. Inter rater reliability was good
(intraclass correlations = 0.91). We used a mixed generalized linear model to assess whether the following explanatory variables
(time, ECT) influenced the course of SIB/AGG over time, the dependant variable. The sample included two girls and two boys.
The mean age at admission was 13.8 years old [range 12–14]. The patients had on average 19 ECT sessions [range 16–26] and
one patient received maintenance ECT. There was no effect of time before and after ECT start. ECT was associated with a significant
decrease in SIB/AGG scores (p < 0.001): mean aggression score post-ECT was half the pre-ECT value. ECT appears beneficial in severe, treatment-resistant
SHBA in adolescents with intellectual disability.
- Content Type Journal Article
- Category Brief Report
- Pages 1-8
- DOI 10.1007/s00787-012-0320-7
- Authors
- Angele Consoli, Department of Child and Adolescent Psychiatry, GH Pitié-Salpêtrière, AP-HP, 47-83, Boulevard de l’Hôpital, 75013 Paris, France
- Johan Cohen, Department of Child and Adolescent Psychiatry, GH Pitié-Salpêtrière, AP-HP, 47-83, Boulevard de l’Hôpital, 75013 Paris, France
- Nicolas Bodeau, Department of Child and Adolescent Psychiatry, GH Pitié-Salpêtrière, AP-HP, 47-83, Boulevard de l’Hôpital, 75013 Paris, France
- Vincent Guinchat, Department of Child and Adolescent Psychiatry, GH Pitié-Salpêtrière, AP-HP, 47-83, Boulevard de l’Hôpital, 75013 Paris, France
- Lee Wachtel, Johns Hopkins School of Medicine, Kennedy Krieger Institute, 707 North Broadway Street, Baltimore, MD 21205, USA
- David Cohen, Department of Child and Adolescent Psychiatry, GH Pitié-Salpêtrière, AP-HP, 47-83, Boulevard de l’Hôpital, 75013 Paris, France
- Journal European Child & Adolescent Psychiatry
- Online ISSN 1435-165X
- Print ISSN 1018-8827