Electroconvulsive Therapy Practice Changes in Older Individuals Due to COVID-19: Expert Consensus Statement.

Area of Science:

• Geriatric Psychiatry
• Infectious Disease Control
• Neuromodulation

Background:

• The COVID-19 pandemic necessitated rapid adaptation in healthcare, including electroconvulsive therapy (ECT).
• ECT involves aerosol-generating procedures, posing infection risks during manual ventilation under anesthesia.
• Older adults are a vulnerable population requiring specific considerations for infection control.

Purpose of the Study:

• To provide a consensus statement on clinical practice changes in ECT for older adults during the COVID-19 pandemic.
• To outline essential modifications for safe and viable ECT service delivery.
• To synthesize expert opinions and a systematic literature review on modified ECT procedures.

Main Methods:

• Consensus statement development through expert group discussions among ECT practitioners nationwide.
• Systematic review of relevant scientific literature.
• Analysis of global approaches to ECT modifications for infection control and operational adjustments.

Main Results:

• Universal consensus affirms ECT as an essential treatment for severe mental illness.
• Clear consensus exists on imperative modifications for safe patient and staff delivery of ECT.
• Global approaches to infection control, procedural alterations, and operational adjustments in ECT are largely uniform.

Conclusions:

• Modified ECT procedures enable continued treatment for older adults while mitigating COVID-19 transmission risks.
• ECT services can remain viable and safe for vulnerable older populations with appropriate modifications.
• Adaptations in ECT practice are crucial for maintaining essential mental healthcare during public health crises.