Clinical Report: Exploring the Factors Contributing to the Limited Use of ECT

Background

Individuals with intellectual and developmental disabilities face significant barriers in accessing healthcare, including mental health services. ECT is a well-established treatment for severe mood and psychotic disorders, yet its use in this population is disproportionately low.

Data Highlights

No numerical data available in the source material.

Key Findings

• Individuals with intellectual and developmental disabilities are more likely to experience conditions like catatonia and severe affective illness, yet receive ECT at lower rates.
• Historical practices in psychiatry have contributed to a legacy of mistrust regarding ECT among individuals with disabilities.
• Modern ECT is administered under general anesthesia with strict consent processes, contrasting with its historical practices.
• Stigmatization of ECT persists, influenced by media portrayals and public perceptions.
• Contemporary ethical frameworks emphasize autonomy and informed consent, complicating the acceptance of ECT for individuals with disabilities.

Clinical Implications

Clinicians should be aware of the historical context and stigma surrounding ECT when discussing treatment options with patients who have intellectual and developmental disabilities. Addressing these concerns may improve access to this effective treatment.

Conclusion

The underutilization of ECT in individuals with intellectual and developmental disabilities highlights the need for ongoing efforts to address stigma and ensure equitable access to mental health treatments.

Related Resources & Content

1. BMC Psychiatry (Springer), 2025 -- Maintenance pharmacotherapy after electroconvulsive therapy in inpatients with major depressive disorder: 198 prescriptions in a real-world clinical setting
2. Frontiers in Psychiatry, 2026 -- Modified electroconvulsive therapy for treatment-resistant self-injurious behavior in autism spectrum disorder with severe intellectual disability: a case report
3. Frontiers in Psychiatry, 2026 -- Identifying clinical features associated with electroconvulsive therapy response in adolescents with major depressive disorder using machine learning
4. BMC Psychiatry (Springer) — A whole population-based cohort study of the trajectory of the prevalence and the incidence of mental illness, challenging behaviour, and psychotropic medication prescribing in adults with intellectual disabilities in the Czech Republic between 2010 and 2022
5. NICE Guidance on ECT
6. American Psychiatric Association's The Practice of Electroconvulsive Therapy
7. AACAP Policy Statement on Electroconvulsive Therapy
8. Evidence-based consensus guidelines for the management of catatonia: Recommendations from the British Association for Psychopharmacology - PMC
9. A unified voice for evidence-based psychiatry: a global response to the WHO guidance on ECT | European Archives of Psychiatry and Clinical Neuroscience | Springer Nature Link
10. Relative effectiveness of antidepressant treatments in treatment-resistant depression: a systematic review and network meta-analysis of randomized controlled trials | Neuropsychopharmacology
11. Ultrabrief pulse electroconvulsive therapy for depression: a systematic review and meta-analysis | Molecular Psychiatry
12. Longitudinal associations of electroconvulsive therapy with all-cause mortality and suicide deaths in severe unipolar or bipolar depression: a systematic review and meta-analysis | BMJ Mental Health
13. ELECTROCONVULSIVE THERAPY IN AUTISM SPECTRUM DISORDERS: AN UPDATE TO THE LITERATURE - PMC
14. Dire Need and Disproportionate Access: ECT In Youth With Autism Spectrum Disorders and Other Neurodevelopmental Disorders - PubMed
15. Frontiers | Opinion: On the reasons for underutilization of ECT in individuals with Intellectual and Developmental Disability