ECT practice in Japan

We sought to determine the characteristics of electroconvulsive therapy (ECT) practice in Japan. Only by knowing practice patterns can standards of care be successfully developed and implemented.

From September 1, 2001, to August 31, 2003, a questionnaire was sent to 248 institutions.

A total of 100 institutions (40.3%) completed the questionnaire. ECT was available in 83 institutions. A total of 1,210 patients received 11,146 ECTs from 895 psychiatrists. Brief-pulse device was used in 21 institutions. EEG monitoring was used routinely in 15 institutions. Bilateral ECT was always used. Patients who received ECT were diagnosed schizophrenia (48.9%), major depression (37.4%), catatonia (6.8%), mania (4.4%), and dysthymia (0.8%). The majority of patients who received ECT were in the age group 45-64 years (40.4%) and 65 years and older (39.3%). A total of 670 patients received a total of 6364 unmodified ECT at 60 institutions. There were no ECT-related deaths during the survey.

ECT use in Japan is low. More than half of ECTs instituted were unmodified. The majority of patients who received ECT were diagnosed with schizophrenia and major depression.