The practice of electroconvulsive therapy in Greece

Area of Science:

• Psychiatry
• Neurology
• Health Services Research

Background:

• Electroconvulsive therapy (ECT) is an effective treatment for severe psychiatric disorders.
• Understanding the current practice patterns and challenges of ECT is crucial for improving mental healthcare delivery.
• Limited data exists on ECT utilization within Greece.

Purpose of the Study:

• To delineate the current landscape of electroconvulsive therapy (ECT) practice in Greece.
• To identify the primary indications, methods, and patient demographics for ECT in the Greek healthcare system.
• To pinpoint obstacles hindering the broader implementation and accessibility of ECT services.

Main Methods:

• A nationwide survey was conducted during the 2008-2009 academic year, focusing on ECT use in 2007.
• Questionnaires were distributed to all civilian inpatient institutions to gather data on ECT provision and utilization.
• Data collected included patient diagnoses, treatment parameters, consent procedures, and perceived barriers to care.

Main Results:

• Electroconvulsive therapy was available in 18 out of 67 surveyed institutions (26.9%), with limited availability in university hospitals.
• In 2007, 137 patients received 1271 ECT sessions, predominantly for schizophrenia (41.3%) and major depression (28.9%).
• Bilateral electrode placement and modified ECT with propofol anesthesia were standard; however, fixed stimulus dosing and outpatient ECT were uncommon, with lack of training and anesthesiologist access cited as major impediments.

Conclusions:

• Electroconvulsive therapy is utilized moderately in Greece, predominantly for inpatient psychiatric care.
• Significant barriers, including inadequate professional training and a shortage of anesthesiologists, restrict ECT's availability and application.
• Addressing these obstacles is essential to optimize the use of ECT as a vital treatment modality.