Pattern of electroconvulsive therapy use in Spain: Proposals for an optimal practice and equitable access

Area of Science:

• Neuroscience
• Psychiatry
• Public Health

Background:

• Electroconvulsive therapy (ECT) is a vital treatment for severe mental health conditions.
• Understanding current ECT utilization patterns is crucial for effective mental healthcare delivery.

Purpose of the Study:

• To estimate the current rates and patterns of electroconvulsive therapy (ECT) use in Spain.
• To identify factors limiting the application of ECT in the country.

Main Methods:

• A comprehensive cross-sectional survey of all Spanish psychiatric units was conducted as of December 31, 2012.
• Data collection focused on the prevalence and distribution of ECT application across different regions and facilities.

Main Results:

• Over half (54.9%) of psychiatric units utilized ECT, with an average rate of 0.66 patients per 10,000 inhabitants.
• Significant variations in ECT application rates were observed across autonomous communities (0.00-1.39) and provinces (0.00-3.90).
• Hospital-level prescribing of ECT showed considerable differences, averaging 25.5 patients in general hospitals versus 4.5 in referral centers.

Conclusions:

• Despite a high percentage of psychiatric units offering ECT, Spain's overall ECT application rate is low compared to other Western nations.
• Substantial disparities in ECT use exist among regions and hospitals, highlighting a need for intervention.
• Implementing targeted health planning strategies and enhancing professional training in ECT are essential to reduce these utilization differences.