Survival Rate Following Involuntary Electroconvulsive Therapy: A Population-Based Study

Area of Science:

• Neuroscience
• Psychiatry
• Public Health

Background:

• Involuntary electroconvulsive therapy (ECT) is a critical intervention for patients with life-threatening conditions unable to consent.
• Limited data on hard outcomes hinders the widespread use of involuntary ECT.
• In Denmark, involuntary ECT is reserved for patients at imminent risk of death.

Purpose of the Study:

• To estimate the 1-year survival rate following involuntary ECT.
• To use survival rate as a proxy for the effectiveness of involuntary ECT.
• To compare survival rates between involuntary ECT, voluntary ECT, and the general population.

Main Methods:

• A register-based cohort study in Denmark (2008-2019).
• Inclusion of patients receiving involuntary ECT, voluntary ECT, and matched population controls.
• Comparison of 1-year survival rates using mortality rate ratios.

Main Results:

• Identified 618 patients receiving involuntary ECT, 547 voluntary ECT, and 3080 controls.
• The 1-year survival rate after involuntary ECT was 90%.
• Involuntary ECT patients had higher mortality rate ratios compared to voluntary ECT (3.1) and general population (5.8).
• Risk factors for early death included male sex, age ≥70, and organic mental disorder indication.

Conclusions:

• Involuntary ECT is associated with a high survival rate, suggesting treatment effectiveness.
• Patients undergoing involuntary ECT represent a high-risk group.
• Close post-treatment monitoring is crucial for patients receiving involuntary ECT.