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Electro Convulsive Therapy in the Treatment of Severe Psychiatric Disorders in Children and Adolescents

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Child and Adolescent Psychiatry

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Abstract

Severe mental disorders endanger the lives and development of children and adolescents. For many of these patients’ other forms of therapy including psychotherapy and pharmacotherapy are not efficient, due to a significant time lag before these interventions may be effective. In many cases, the patient may have already failed several pharmacological trials and psychotherapeutic interventions. This chapter will discuss electroconvulsive therapy (ECT) in the treatment of severe psychiatric disorders in children and adolescents, in particular treatment resistant mood disorders, catatonia, psychotic spectrum disorders, and self-injurious behaviors. A course of ECT includes a few brief well-monitored electrically-induced brain convulsive activity of the anesthetized patient, often followed by a rapid at times lifesaving response. Stigma and ignorance about the use of ECT especially in treating children and adolescents is a widely prevalent problem; thus depriving many sufferers from the probable benefits of this therapeutic modality. The use of ECT is complex and demands taking into account ethical questions, patients’ rights, and following legal regulations that vary between different places in the world. ECT requires a well-coordinated professional team with expertise in the field. It demands updated equipment, prudent patient selection, a comprehensive treatment plan, and psychiatric, cognitive, and physical monitoring during and after the treatment course. This chapter presents current evidence about the use of ECT, underscoring clinical knowledge and guidelines in the field.

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Abbreviations

ECT:

Electro convulsive therapy

BL:

Bilateral electrode placement while performing ECT

UL:

Unilateral electrode placement (usually right) while performing ECT

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Authors and Affiliations

  1. University of Michigan, Ann Arbor, USA

    Yuval Bloch & Neera Ghaziuddin

  2. “Shalvata” Mental Health Center, Hod Hashron, Israel

    Yuval Bloch & Neera Ghaziuddin

  3. Sacker School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Yuval Bloch & Neera Ghaziuddin

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  1. Yuval Bloch
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  2. Neera Ghaziuddin
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Correspondence to Yuval Bloch .

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  1. Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, Chandigarh, India

    Savita Malhotra

  2. Child and Adolescent Mental Health Serv., Centre for Interventional Paediatric(CIPPRD) Child and Adolescent Mental Health Serv., London, United Kingdom

    Paramala Santosh

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Bloch, Y., Ghaziuddin, N. (2016). Electro Convulsive Therapy in the Treatment of Severe Psychiatric Disorders in Children and Adolescents. In: Malhotra, S., Santosh, P. (eds) Child and Adolescent Psychiatry. Springer, New Delhi. https://doi.org/10.1007/978-81-322-3619-1_19

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