Electroconvulsive Therapy: A German Perspective

A survey was undertaken in 1986 to provide reliable information on the present status of electroconvulsive therapy (ECT) in the Federal Republic of Germany (FRG). ECT was used in 26% of the state mental hospitals, 40% of the psychiatric departments of general hospitals, and in 78% of university hospitals. The number of treatment courses applied was low, with about 500 patients receiving ECT in 1985. The indications for ECT and patterns of administration appeared similar to those of other countries, although unilateral electrode placement was prescribed infrequently. The low use of ECT in the FRG (0.08/10,000 population) cannot be related to the attitudes of senior psychiatrists toward ECT, because the attitudes appear to be rather favorable. The majority maintained that indications for ECT exist and that every psychiatric hospital with comprehensive treatment facilities should offer this treatment. ECT usage seems to be partly determined by nonmedical factors, in particular, the recent attacks against psychiatry and ECT in the media. To correct the consequences of such attacks, the merits of ECT should become better known.