Racial Disparities in Electroconvulsive Therapy: A Study From Singapore

Area of Science:

• Psychiatry
• Neuroscience
• Public Health

Background:

• Electroconvulsive therapy (ECT) is a vital psychiatric treatment.
• Previous studies noted racial disparities in ECT use in Western countries.
• This study investigates racial differences in ECT utilization and outcomes in Singapore's diverse population.

Purpose of the Study:

• To examine racial variations in electroconvulsive therapy (ECT) use and outcomes.
• To compare ECT effectiveness and safety among Chinese, Malay, and Indian patients in Singapore.
• To explore potential differences in subjective post-ECT experiences across racial groups.

Main Methods:

• Retrospective analysis of 1091 patient records from Singapore Institute of Mental Health (IMH) between 2017-2023.
• Collected data included sociodemographics, clinical characteristics, and pre/post-ECT outcomes.
• Compared ECT response rates and cognitive outcomes across Chinese, Malay, and Indian participants.

Main Results:

• No significant racial differences in ECT response rates (Chinese: 48.3%, Indian: 40.4%, Malay: 42.7%) or cognitive outcomes.
• Chinese participants were older, more likely female, and showed significantly better post-ECT utility scores.
• No racial differences observed in primary diagnosis, medication failures, or prior ECT history.

Conclusions:

• ECT efficacy and safety appear consistent across Chinese, Malay, and Indian populations in Singapore.
• Higher post-ECT quality of life scores in Chinese patients may indicate differing subjective experiences or perceived utility.
• Findings contribute to understanding ECT in a non-Western, multiracial context, supporting its equitable application.