Historical Highlights on Electroconvulsive Therapy Practice in Iraq: A Brief Narrative

Electroconvulsive therapy (ECT) is an established treatment option for severe psychiatric disorders. Electroconvulsive therapy practice began in Iraq in 1946, primarily to treat patients with schizophrenia. Since then, it has developed and expanded to treat mood disorders and major depression. Initially, both modified and unmodified ECT was administered to patients in Ibn Rushd and Al Rashad mental hospitals in Baghdad. The ongoing political turmoil from 3 wars, economic sanctions, and internal conflicts halted the development of mental health services across the country; ECT provision was not an exception. The practice of unmodified ECT-without general anesthesia-ceased in 2009, after the recommendations of the Royal College of Psychiatrists' Iraq Subcommittee. This closure reduced the availability and accessibility of ECT clinics nationwide because of limited access to general anesthesia. This article explores the nature of ECT services, in the context of Iraq's health care system, sociocultural norms, instability, and international codes of practice. This brief report uses the first author's work experience, few available data, and personal communication to describe the brief history of ECT practice in Iraq. This report is a baseline document for future ECT practice regulation in Iraq.