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Rates of electroconvulsive therapy use in Edinburgh (1992-1997)
Background:
The number of ECT treatments given each year is a topic of interest for psychiatrists, users and politicians, but there are major methodological problems in reported studies of rates of ECT use in the British Isles. The aim was to establish whether or not the use of ECT had fallen between 1992 and 1997.
Method:
A computerised database of ECT treatments in Edinburgh and relevant population data were used to calculate annual indices of ECT usage. These indices were calculated separately for the population aged 18-64 years and those 65 years or older.
Results:
In the general adult population, the rate of ECT use fell progressively and significantly (p < 0.01) from 2.90 to 1.37 treatments per 1000 population. This fall was commensurate with the falls in other indices of ECT use. Among the elderly population, the rate of ECT use was three times that in the general adult population. There was no significant change, although the number of courses of treatment fell by 40% (p = 0.06).
Conclusions:
There continues to be a progressive fall in the use of ECT in general adult psychiatry. ECT is used substantially more often in the elderly. Reports of ECT use ought to include numbers of both treatments and patients treated.
Limitations:
There was no investigation of the possible causes of the fall in ECT use. The extent to which these findings can be generalised to the rest of the British Isles will require further study.
