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Epidemiologic considerations in electroconvulsive therapy.

H M Babigian, L B Guttmacher

    Archives of General Psychiatry
    |March 1, 1984
    PubMed
    Summary
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    Electroconvulsive therapy (ECT) use declined, especially for young women, and became more specific for depression cases between 1961-1975. Mortality was not significantly affected, but hospital stays were longer for ECT patients.

    Area of Science:

    • Psychiatry
    • Epidemiology
    • Public Health

    Background:

    • Electroconvulsive therapy (ECT) remains a treatment option for severe mental health conditions.
    • Understanding trends in ECT utilization, patient demographics, and outcomes is crucial for clinical practice and health policy.
    • Longitudinal data analysis provides insights into treatment evolution over time.

    Purpose of the Study:

    • To analyze trends in electroconvulsive therapy (ECT) incidence, prevalence, mortality, and length of stay.
    • To examine changes in ECT utilization patterns for depression over three decades.
    • To identify demographic and diagnostic factors associated with ECT use.

    Main Methods:

    • Analysis of data from the Monroe County Psychiatric Case Register spanning 1961-1975.

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  • Grouped data into three 5-year periods for comparative analysis of incidence, prevalence, mortality, and length of stay.
  • Statistical examination of demographic characteristics, diagnostic correlates, and mortality rates.

    • Main Results:

    • A substantial decline in the incidence of first ECT series was observed across most age-sex groups from 1961-1965 to 1971-1975.
    • Significant decreases in the prevalence of ECT admissions were noted primarily among young female patients.
    • Both incidence and prevalence analyses indicated increasing specificity of ECT use for depression cases over time.
    • Mortality effects associated with ECT were not pronounced; a lower rate of accidental and circulatory deaths was observed in the ECT group.
    • Patients receiving ECT generally had longer hospital stays compared to other depression hospitalizations.

    Conclusions:

    • ECT utilization has decreased and become more targeted for depression over the studied period.
    • While overall incidence declined, prevalence changes varied by demographic group.
    • ECT appears to have a neutral to potentially beneficial effect on mortality, with longer hospitalizations being a notable characteristic.