Neera Ghaziuddin

Electroconvulsive Therapy in Children and Adolescents

This is a pioneering book and is the first book of its kind. The book offers guidance about the use of ECT in adolescents with up to date and concise information. The editors of the book are Neera Ghaziuddin MD, MRCPsych (University of Michigan, Ann Arbor, USA), and Garry Walter, MD, Ph.D. (University of Sydney, Australia) who spear-headed the re-introduction of ECT as a safe and an effective treatment option for a subgroup of adolescents with severe psychiatric disorders. This book offers a review of the existing literature, firsthand experience of the authors 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.