Electroconvulsive Therapy and All-Cause Mortality in Texas, 1998-2013

Area of Science:

• Neuroscience
• Psychiatry
• Public Health

Background:

• Electroconvulsive therapy (ECT) is an established treatment for major depressive disorder.
• Texas has maintained a comprehensive ECT database since 1995, capturing patient diagnoses and outcomes.
• The study analyzes 166,711 ECT treatments administered in Texas between 1998 and 2013.

Purpose of the Study:

• To assess the safety of electroconvulsive therapy (ECT) by analyzing death rates within a 14-day period post-treatment.
• To identify demographic and diagnostic factors associated with mortality following ECT.
• To evaluate the overall risk profile of ECT in a large patient cohort.

Main Methods:

• Descriptive analysis of reported deaths, including cause, treatment type, and patient demographics.
• Logistic regression analysis to determine associations between patient characteristics (age, sex, race, diagnosis, treatment year) and death incidence after ECT.

Main Results:

• The death rate within 1 day of ECT was 2.4 per 100,000 treatments.
• The death rate within 14 days of ECT was 18 per 100,000 treatments, including all causes.
• Increased death rates were significantly associated with older patient age and male sex. A trend towards increased mortality was observed in patients with bipolar disorder or schizophrenia compared to depression.

Conclusions:

• Electroconvulsive therapy (ECT) is generally a safe procedure with a low likelihood of immediate death.
• Suicide poses a significant risk to patients receiving ECT, even though the therapy can reduce suicidal ideation.