Electroconvulsive therapy use in New South Wales between 1944 and 1949

Area of Science:

• Psychiatry
• Medical History

Background:

• Electroconvulsive therapy (ECT) is a medical procedure most commonly used for patients with severe major depression or other certain mental health conditions.
• Historical data on the application and outcomes of ECT provides valuable insights into evolving psychiatric treatment practices.

Purpose of the Study:

• To identify clinical and demographic factors associated with electroconvulsive therapy (ECT) use in New South Wales (NSW) between 1944 and 1949.
• To compare mid-20th century ECT practices with contemporaneous psychiatric treatments.

Main Methods:

• Analysis of annual reports from the Inspector-General of Mental Hospitals in NSW.
• Data collection covered the period from 1944/45 to 1948/49, encompassing seven hospitals and 8964 reported ECT courses.

Main Results:

• Females constituted 60.6% of patients receiving ECT; rural hospitals accounted for 13.6% of treatments.
• ECT was administered for affective psychoses (35.0%), non-affective psychoses (37.7%), confusional states, and non-psychotic disorders.
• Outcomes were better for depression, anxiety, and confusional states compared to non-affective psychoses, with a noted decline in recovery rates over the study period. Mortality was less than 1%.

Conclusions:

• Clinical indications for ECT in mid-20th century NSW were significantly broader than current practices.
• The sex ratio of patients receiving ECT and the reported mortality rate have remained consistent over time.