Electroconvulsive therapy in Belgium: a nationwide survey on the practice of electroconvulsive therapy

To review and describe the practice of electroconvulsive therapy (ECT) in Belgium.

A 30-item questionnaire on the practice of ECT was sent to all institutions providing ECT.

In 2003 ECT was offered in 32 hospitals. Although ECT hospitals are equally spread over three regions, there is a significant difference in the ECT utilization rate. There are no major regional differences in the practice of ECT. Fifty-three percent of the hospitals reported less than 10 treatment sessions per month. The major indication for ECT was depression (89.7%). Propofol was the anesthetic most commonly used (75%). Eleven departments (34.3%) used a sine wave device. Bitemporal electrode placement was the preferred option in 65.6% of all departments, and 37% of these used the combination of bitemporal electrode placement and a fixed high stimulus dose. Continuation ECT and outpatient ECT were rarely used.

This questionnaire study relies upon answers given by psychiatrists, and did not audit actual practices.

Although ECT is widely available in Belgium, it remains underused and the practice of ECT is amenable for improvement. Guidelines should be implemented and continuing education is needed.