Electroconvulsive Therapy Practice in Thailand: A Nationwide Survey

Area of Science:

• Psychiatry
• Neurology
• Clinical Practice

Background:

• Electroconvulsive therapy (ECT) is a vital treatment for severe psychiatric disorders.
• Understanding current ECT practices in Thailand is crucial for service improvement.

Purpose of the Study:

• To characterize the current landscape of electroconvulsive therapy (ECT) practice across Thailand.
• To identify trends and areas for development in ECT services nationwide.

Main Methods:

• A nationwide cross-sectional survey was conducted.
• Questionnaires were distributed to all 34 hospitals providing ECT services.
• Data on diagnoses, devices, electrode placement, anesthesia, and treatment protocols were collected.

Main Results:

• Schizophrenia, bipolar disorder, and major depressive disorder were the most common indications.
• Brief pulse devices and modified ECT were universally adopted.
• Bitemporal electrode placement was most frequent, with titration used for initial dosing.
• Thiopentone and propofol were primary anesthetics; headache and cognitive effects were common adverse events.

Conclusions:

• ECT practice in Thailand has significantly evolved, with widespread adoption of modified ECT and brief pulse devices.
• While efficacy and safety measures are increasingly implemented, further improvements in ECT education for clinicians are recommended.
• Continued monitoring and refinement of ECT protocols can optimize patient outcomes.