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Use of ECT in Autism Spectrum Disorder and/or Intellectual Disability: A Single Site Retrospective Analysis

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Abstract

Autism spectrum disorder (ASD) and intellectual disability (ID) are heterogenous and prevalent conditions which may occur in isolation or as a co-morbidity. Psychiatric co-morbidity is common with limited treatment options. Preliminary research into electroconvulsive therapy (ECT) for these conditions has been encouraging. Thus, further research in this patient population is warranted. We conducted a 10-year retrospective review of the electronic medical record and identified intellectually capable individuals with ASD (IC-ASD), and those with ASD+ID or ID who received at least three ECT treatments. 32 patients were identified of which 30 (94%) experienced positive clinical response, defined as a clinical global impression-improvement (CGI-I) score of 3 or less. The average retrospective CGI-I score across all groups was 1.97, and results of a t-test performed on CGI-I scores indicated improvement across all groups [t = − 16.54, df = 31, p < 0.001, 95% CI = (1.72, 2.22)]. No significant adverse events were identified based on clinical documentation. Our findings further support previous ECT research in this patient population.

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Data Availability

The data that support the findings of this study are available from the corresponding author, JRS, upon request.

Abbreviations

ASD:

Autism spectrum disorder

NDD:

Neurodevelopmental disorder

ASD+ID:

Autism spectrum disorder with co-morbid intellectual disability

ID:

Intellectual disability

IC+ASD:

Intellectually capable autism spectrum disorder

ECT:

Electroconvulsive therapy

NT:

Neurotypical

CGI-I:

Clinical global impressions improvement scale

mECT:

Maintenance ECT

SNAE:

Seronegative autoimmune encephalitis

SGA:

Second-generation antipsychotic

BFCRS:

Bush Francis Catatonia Rating Scale

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Acknowledgments

None.

Funding

This work was supported by the National Institute of Mental Health (R25MH094612, JL). The sponsors had no role in study design, writing of the report, or data collection, analysis, or interpretation. Institutional Review Board approval was granted for this study.

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Authors and Affiliations

Authors

Contributions

JRS: conceptualization, methodology, investigation, data curation, investigation, writing—original draft, supervision. CS: conceptualization, methodology, investigation, writing—review and editing. JX: formal analysis, investigation, data curation, writing—original draft. JL: conceptualization, writing—review and editing. ES: conceptualization, writing—review and editing, supervision. SV: formal analysis, investigation, data curation, writing—review and editing, supervision.

Corresponding author

Correspondence to Joshua R. Smith.

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Conflict of interest

None.

Ethical Approval

We received institutional review board approval from Vanderbilt University Medical Center to waive consent and review, analyze, and report anonymously on these patients (IRB Number: 211979).

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Smith, J.R., Hopkins, C.E., Xiong, J. et al. Use of ECT in Autism Spectrum Disorder and/or Intellectual Disability: A Single Site Retrospective Analysis. J Autism Dev Disord 54, 963–982 (2024). https://doi.org/10.1007/s10803-022-05868-6

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  • DOI: https://doi.org/10.1007/s10803-022-05868-6

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