European Child & Adolescent Psychiatry

, Volume 22, Issue 1, pp 55–62 | Cite as

Electroconvulsive therapy in adolescents with intellectual disability and severe self-injurious behavior and aggression: a retrospective study

  • Angele Consoli
  • Johan Cohen
  • Nicolas Bodeau
  • Vincent Guinchat
  • Lee Wachtel
  • David Cohen
Brief Report

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.

Keywords

Electroconvulsive therapy Self-injurious behavior Aggression Intellectual disability Pervasive developmental disorder 

Notes

Acknowledgments

The authors thank all the patients and their families for participating despite invaliding conditions. Grants from the Foundation Pfizer funded AC. The funding agencies were not involved in the study design, collection, analysis and interpretation of data, writing of the paper, and/or the decision to submit for publication.

Conflict of interest

Dr. Consoli reported receiving travel support from Bristol-Myers Squibb and Pr. Cohen reported past consultation for or the receipt of honoraria from Schering-Plough, Bristol-Myers Squibb, Otsuka, Janssen, Shire, and Sanofi-Aventis. Dr L. Wachtel, Dr V. Guinchat, Dr. J. Cohen and N. Bodeau declare that they have no conflict of interest. No authors have any non-financial interests that may be relevant to the submitted work.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Angele Consoli
    • 1
    • 2
  • Johan Cohen
    • 1
  • Nicolas Bodeau
    • 1
  • Vincent Guinchat
    • 1
  • Lee Wachtel
    • 3
  • David Cohen
    • 1
    • 4
  1. 1.Department of Child and Adolescent PsychiatryGH Pitié-SalpêtrièreParisFrance
  2. 2.INSERM U-669, PSIGIAM, MDAGH CochinParisFrance
  3. 3.Johns Hopkins School of MedicineKennedy Krieger InstituteBaltimoreUSA
  4. 4.CNRS UMR 7222, Institut des Systèmes Intelligents et Robotiques, Université Pierre et Marie CurieGH Pitié-SalpêtrièreParisFrance

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