Psychiatrists’ Knowledge, Attitudes, and Practices Regarding the Use of Modified Electroconvulsive Therapy in Adolescents With Major Depressive Disorder: A Cross-Sectional Survey in Chongqing, China

Abstract

Background: Adolescent major depressive disorder (MDD) is a serious condition often resistant to treatment. Despite established efficacy in adults, modified electroconvulsive therapy (MECT) remains limited and controversial in youth. This study examined psychiatrists’ knowledge, attitudes and practices (KAPs) regarding MECT for adolescent MDD, along with their interrelationships and associated factors.

Methods: A cross-sectional online survey was conducted (May–July 2025) amongst psychiatrists in Chongqing, China. Using a validated KAP questionnaire, data were collected via WeChat and examined via descriptive, correlation and regression analyses.

Results: Amongst the 125 questionnaires distributed, 113 valid responses were analysed (90.4%). Psychiatrists showed moderate knowledge (3.31 ± 0.88), positive attitude (3.68 ± 0.51) and moderate practice (3.09 ± 0.98) levels regarding MECT. KAPs were positively correlated. Higher professional level (attending physician: β = 0.374, p = 0.007; associate senior or above: β = 0.470, p = 0.004) significantly predicted greater knowledge. Better knowledge (β = 0.225, p = 0.028) predicted more positive attitude. Higher knowledge (β = 0.496, p < 0.001) and attitude (β = 0.226, p = 0.006) significantly predicted greater MECTrelated practice. Working in a specialized psychiatric hospital (β = –0.525, p < 0.001) and clinical experience greater than 20 years (β = 0.324, p = 0.030) were significantly associated with practice. 

Conclusions: Psychiatrists in Chongqing showed positive attitude but only moderate knowledge and practice regarding MECT for adolescent MDD. Enhancing clinician education and addressing patient- and system-level barriers may help promote appropriate MECT use.