The efficacy of ECT in adults with mental retardation experiencing psychiatric disorders

There is a paucity of empirical data establishing the efficacy of electroconvulsive therapy (ECT) in patients with mental retardation and psychiatric disorders. This study examines the efficacy of ECT on specific symptoms and between psychiatric diagnoses in patients with mental retardation who are psychiatrically ill. A chart review was performed on 20 inpatients who had received ECT on a dedicated Mental Retardation-Dual Diagnosis Unit and were divided into 3 categories: mood disorders (n = 12), psychotic disorders (n = 6), and intermittent explosive disorder (n = 2). Ratings were performed 1 week before ECT treatment and 1-week after its termination using the Aberrant Behavior Checklist and the Clinical Global Impressions Severity Scale. A repeated-measures analysis of variance comparing Aberrant Behavior Checklist scale scores revealed a significant time-by-treatment interaction (F = 75.43, df = 1,9, P = 0.000, 2 t). The mood disorder and psychotic disorder groups had significantly lower irritability and hyperactivity scores after treatment compared with the intermittent explosive disorder group. The Clinical Global Impressions Severity Scale rating scores showed significant improvement in the mood disorders group (67%), in contrast to the intermittent explosive disorder group (0%). Our data suggests the utility of ECT for patients with mental retardation who also have treatment-resistant mood disorders and psychotic disorders, particularly with symptoms of hyperactivity and irritability. The data are sufficiently encouraging to justify prospective research of this question.