[Electroconvulsive therapy as a "last resort" in the treatment of depression?]

The use of electroconvulsive therapy (ECT) in treatment-resistant depressed patients is supported by numerous international guidelines. This study aims to describe what type of patients are actually referred to treatment with ECT.

We included all patients referred to two main ECT-treatment centers in Switzerland during the period of August 2008 to February 2011. We collected data on the diagnosis, severity of illness, and the history of treatment.

Most of the patients (n = 104) were referred after an average of 124 weeks of an index episode of unipolar depression. The patients were severely and chronically ill and had been treated on average for more than a decade. Eighty-three percent of the patients were referred for ECT treatment for the first time.

The surveyed practice of referral does not concur with evidence-based guidelines for the use of ECT in the treatment of depression.