This is a pioneering book about the use of ECT in adolescents who are diagnosed with severe, disabling psychiatric disorders or fail conventional treatment. Included are a review of the literature, firsthand experience of the authors and case descriptions making it an invaluable guide to treatment.

This pioneering book is the first book of its kind and offers guidance about the use of ECT in youth with up-to-date and concise information. The editors, Neera Ghaziuddin MD, MRCPsych (University of Michigan, Ann Arbor, USA), and Garry Walter, MD, PhD (University of Sydney, Australia), have spearheaded the re-introduction of ECT as a safe and an effective treatment option for a subgroup of children and adolescents with severe psychiatric disorders. This book offers a review of the existing literature, firsthand experience of the authors who are regarded as experts in their respective field, and highly informative case descriptions. The book also offers a historical perspective, explaining the reasons why ECT fell out of favor, particularly among child and adolescent psychiatrists, and the resulting lost opportunity to train clinicians over many decades. Starting around the 1990's, there has been a revival of interest, probably due to the recognition of treatment resistance among some adolescents. The chapter about the mechanism of action ECT describes biological mechanisms that are known to underlie mental illness. Other chapters include a discussion about stigma associated with ECT, ethical and informed consent issues, a step-by-step guidance about using ECT, use of anesthesia during ECT and the interaction between ECT and medications. In addition, its use in youth with general medical and neurological disorders is described. The chapter detailing side effects of the treatment dispels misinformation and indicates that ECT is a safe, painless and a highly effective procedure which is not associated with any lasting side effects. The use of ECT in the treatment of specific disorders (mood and psychotic disorders, severe self-injury and catatonia) is described under respective chapters using case examples. Lay readers, families and patients considering this treatment will find the question and answer subsections at the end of each chapter useful. The experience of the editors gives a unique insight to ECT, dispelling myths and stigma and guides the reader about its proper use.

The fourth edition of this popular Handbook provides the latest guidance on prescribing and administering electroconvulsive therapy (ECT). Leading researchers and practitioners review new research on ECT and related treatments, including their efficacy in children and adolescents, and in those with bipolar disorder and neurological conditions. With a focus on safe provision and minimisation of side effects, it provides the reader with practical, evidence-based advice. The book has been substantially revised: references have been updated throughout; related treatment modalities such as rTMS, tCDS and ketamine are covered in greater depth; and current administrative and legal framework guidelines are clearly outlined. An essential reference manual for consultant and trainee clinical psychiatrists, as well as ECT practitioners. This guide will benefit clinical teams looking after complex cases of depression, as well as those involved in the care of other people for whom ECT may be recommended.

Since the development of pharmacoconvulsive therapy in 1934 and of electroconvulsive therapy (ECT) in 1938, ECT has proven far more valuable than just the intervention of last resort. In comparison with psychotropic medications, we now know that ECT can act more effectively and more rapidly, with substantial clinical improvement that is often seen after only a few treatments. This is especially true for severely ill patients -- those with severe major depression with psychotic features, acute mania with psychotic features, or catatonia. For patients who are physically debilitated, elderly, or pregnant, ECT is also safer than psychotropic medications. The findings of the American Psychiatric Association (APA) Task Force on ECT were published by the APA in 1990 as the first edition of The Practice of Electroconvulsive Therapy, inaugurating the development of ECT guidelines by groups both within the United States and internationally. Since then, advances in the use of this technically demanding treatment prompted the APA to mandate a second edition. The updated format of this second edition presents background information followed by a summary of applicable recommendations for each chapter. This close integration of the recommendations with their justifications makes the material easy to read, understand, and use. To further enhance usability, recommendations critical to the safe, effective delivery of treatment are marked with the designation "should" to distinguish them from recommendations that are advisable but nonessential (with the designations "encouraged," "suggested," "considered"). The updated content of this second edition, which spans indication for use of ECT, patient evaluation, side effects, concurrent medications, consent procedures (with sample consent forms and patient information booklet), staffing, treatment administration, monitoring of outcome, management of patients following ECT, and documentation, as well as education, and clinical privileging. This volume reflects not only the wide expertise of its contributors, but also involved solicitation of input from a variety of other sources, including applicable medical professional organizations, individual experts in relevant fields, regulatory bodies, and major lay mental health organizations. In addition, the bibliography of this second edition is based upon an exhaustive search of the clinical ECT literature over the past decade and contains more than four times the original number of citations. Complemented by extensive annotations and useful appendixes, this remarkably comprehensive yet practical overview will prove an invaluable resource for practitioners and trainees in psychiatry and related disciplines.

Electroconvulsive therapy (ECT) is a psychiatric treatment involving the induction of a seizure through the transmission of electricity in the brain. Because of exploitation movies and greatly heightened drug company promotional activities ECT was used less frequently in the 1980s and 1990s. Eventually these movies were understood as unrealistic. Now these drugs are increasingly recognized as dangers to body health. Because of recent refinements and a far better scientific understanding of the clinical procedures and mechanisms underpinning ECT, this treatment modality has seen a resurgence in use and widespread appreciation of its safety. This book is the new definitive reference on electroconvulsive and neuromodulation therapies. It comprehensively covers the scientific basis and clinical practice of ECT as well as comparisons between ECT and medication therapies including the new generation of antipsychotic drugs. It also provides readers with administrative perspectives and specific details for the management of this modality in clinical practice. The new forms of nonconvulsive electrical and magnetic brain stimulation therapy are also covered in detail, in a separate section. The chapter authors are leading scholars and clinicians.

Guest edited by Drs. Jonathan Essary Becker and Christopher Todd Maley, this issue of Child and Adolescent Psychiatric Clinics will cover several key areas of interest related to Neuromodulation in Child and Adolescent Psychiatry. This issue is one of four selected each year by our series Consulting Editor, Dr. Todd Peters. Articles in this issue include: Ethical/Legal issues with neuromodulation, Pediatric anesthesia and ECT, TMS, depression, and adolescents, Psychosis and ECT in children/adolescents, Anti-NMDA receptor encephalitis and ECT, Autism and ECT, Catatonia and children/adolescents and ECT, and Transcranial direct current stimulation.

In an attempt to explore the explanations why psychiatrists continue to use electroshock with minors already at risk from damage, this text investigates reasons why electroshock remains popular, despite the widespread availability of proven psychosocial alternatives. The text locates all of the literature since the 1940s about the use of electroshock with minors from three years of age through adolescence. Since the introduction of shock with children and teenagers, the province of psychiatry has been expanded to include minors as young as three. A fifty-year overview of shock use by psychiatrists with minors is provided, with an analysis of reasons for its popularity among some medical staff. The review includes results from a meta-analysis study that reports data from over 200 previously published clinical cases. These results indicate that there is no clinical rationale for the use of shock with children and teenagers. Moreover, there are many reasons not to give shock, including ethical, philosophical, moral, and humanistic objections. The continued use of electroshock by psychiatrists persists only due to the clinical independence of medical staff. There are no controlled evaluations, no randomized controlled trials, no controlled clinical trials, and no single case studies that report outcome data from electroshock given under scientific conditions to minors. Rather, the entire published literature is based on anecdotal reports from uncontrolled interventions. The text explores the ethical position of mental health staff who are in the same arena. Alternatives to electroshock are explored in the context of services for children and teenagers with mental health needs.

This book is the need-to-know guide to the practice of modern electroconvulsive therapy.

In the fall of 2009, Amy Lutz and her husband, Andy, struggled with one of the worst decisions parents could possibly face: whether they could safely keep their autistic ten-year-old son, Jonah, at home any longer. Multiple medication trials, a long procession of behavior modification strategies, and even an almost year-long hospitalization had all failed to control his violent rages. Desperate to stop the attacks that endangered family members, caregivers, and even Jonah himself, Amy and Andy decided to try the controversial procedure of electroconvulsive therapy or ECT. Over the last three years, Jonah has received 136 treatments. His aggression has greatly diminished, and for the first time Jonah, now fourteen, is moving to a less restricted school. Each Day I Like It Better recounts the journeys of Jonah and seven other children and their families (interviewed by the author) in their quests for appropriate educational placements and therapeutic interventions. The author describes their varied, but mostly successful, experiences with ECT. A survey of research on pediatric ECT is incorporated into the narrative, and a foreword by child psychiatrist Dirk Dhossche and ECT researcher and practitioner Charles Kellner explains how ECT works, the side effects patients may experience, and its current use in the treatment of autism, catatonia, and violent behavior in children.

In How Everyone Became Depressed, Edward Shorter, a distinguished professor of psychiatry and the history of medicine argues for a return to the old fashioned concept of nervous illness.