[Electroconvulsion therapy for persistent depression in the Netherlands; very low application rate]

Area of Science:

• Psychiatry
• Clinical Psychology
• Health Services Research

Background:

• Persistent depressive disorder affects 20% of all depressive disorders and is often treatment-resistant.
• Electroconvulsive therapy (ECT) is the most potent treatment for severe depression.
• Dutch guidelines recommend ECT for persistent depression after 12 months of inadequate treatment.

Purpose of the Study:

• To quantify the utilization of electroconvulsive therapy (ECT) in persistent depressive disorder patients in the Netherlands.

Main Methods:

• Quantitative research utilizing the Dutch diagnosis-treatment-combination (DBC) information system (DIS).
• Data sourced from the Dutch Healthcare Authority (NZa) for the year 2014.
• Analysis focused on patients diagnosed with unipolar depression for over two years.

Main Results:

• In 2014, 23,597 patients (26%) with unipolar depression had a persistent depressive episode.
• Only 278 patients (1.2%) from this persistent depression group received ECT.
• A significant disparity exists between the number of patients eligible for ECT and those who received it.

Conclusions:

• ECT is significantly underused in the Netherlands for persistent depression, with only 1.2% of eligible patients receiving it.
• The low application rate may stem from insufficient professional knowledge of ECT or premature use of the handicap model.
• Further investigation into barriers preventing ECT use is warranted to improve patient outcomes.