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Electroconvulsive therapy for Patients with Intellectual Disability. When and how?

Published online by Cambridge University Press:  01 September 2022

F. Azevedo*
Affiliation:
Centro Hospitalar de Lisboa Ocidental, Psychiatry, Lisbon, Portugal
R. André
Affiliation:
Centro Hospitalar Universitário Lisboa Norte, Psychiatry, Lisboa, Portugal
I. Donas-Boto
Affiliation:
Centro Hospitalar de Lisboa Ocidental, Psychiatry Department, Lisboa, Portugal
D. Jeremias
Affiliation:
Centro Hospitalar de Lisboa Ocidental, Psychiatry, Lisbon, Portugal
C. Almeida
Affiliation:
NOVA Medical School, Psychiatry And Mental Health, Lisboa, Portugal
*
*Corresponding author.

Abstract

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Introduction

Intelectual disability is an illness with an important burden on patients and caregivers, especially when severe and when comorbidities such as other psychiatric disorders are present. There are case reports of treatment resistant self-aggression, agitation, epilepsy, catatonia and psychosis successfully treated with electroconvulsive therapy although controlled studies were not found.

Objectives

This work reviewed the current evidence for the use of electroconvulsive therapy in the management of patients with intellectual disability as well as its ethical and methodological implications.

Methods

Non-systematic review of the literature with selection of scientific articles published in the past 20 years; by searching Pubmed and Medscape databases using the combination of MeSH descriptors. The following MeSH terms were used: “electroconvulsive therapy”, “intellectual disability”.

Results

Patients with intellectual disability can have incapacitating comorbilities that greatly impair quality of life, and may require withdrawl from the community Treatment often differs from the general population as psychotropic medication can worsen other comorbilities. Electroconvulsive therapy can be a relevant treatment option for comorbidities in this population due to its safety profile. Ethical considerations should be taken into account, especially with non-verbal patients or when adequate representatives have not been chosen or cannot be reached. Different legal challenges may be present on different countries.

Conclusions

Electroconvulsive therapy and intellectual disability share the burdens of heavy stigma and low investment. Intellectual disability and it’s commorbidites present both a diagnostic and treatment challenge. Electroconvulsive therapy is an important weapon capable of restoring patients to their families and diminishing the burdens of caregivers and healthcare systems

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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