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Use of ECT in patients with an intellectual disability: review
- Authors:
- COLLINS Jessica, HALDER Neel, CHAUDHRY Nasim
- Journal article citation:
- Psychiatrist (The), 36(2), February 2012, pp.55-60.
- Publisher:
- Royal College of Psychiatrists
Although adults with an intellectual disability display a higher prevalence of psychiatric disorders than in the general adult population, the existing literature on the use of electroconvulsive therapy (ECT) in patients with an intellectual disability is limited. This review examined articles on ECT published before March 2010. All age ranges, severity of disability and diagnoses were included. The review found 72 case reports, a retrospective chart review study and other reviews, but no controlled studies. Seventy nine per cent of patients showed a positive outcome following ECT. Complications were seen only in 13% and there were no reports of cognitive decline. Thirty two per cent of patients relapsed following ECT, and the majority were maintained with medication at follow-up (71%). Obstacles to its use include diagnostic difficulties, ethical and legal issues, a lack of objective measurements and uncertainty about its safety in this population. The authors concluded that ECT was a valuable treatment for this patient group and should be considered earlier as opposed to as a last resort.