Psychiatrists who use and do not use ECT: a comparative study

Cross-section survey data were used to test eight hypotheses derived from the New Haven studies of psychiatric treatment practices. Eighty percent of the psychiatrists in Maryland completed a 10-page questionnaire, and those 29 who had used electroconvulsive therapy (ECT) during the preceding year were compared with 441 who had not. Respondents did not differ significantly from non-respondents or from respondents to a national survey in distribution by demographic variables. Five hypotheses were supported: ECT users are less frequently psychoanalytically trained, treat more working- and lower-class patients, use more pharmacotherapy, use less intensive psychotherapy, and use less psychoanalysis. The hypotheses that ECT users are more frequently affiliated with public hospitals and use more short-term psychotherapy were not supported, and the hypothesis that ECT users are less frequently Jewish was refuted. Other noteworthy findings are that none of the female psychiatrists or child psychiatrists in this sample used ECT, and that ECT users used less behavior therapy. These data on ECT users are more consistent with the recent concept of a somatotherapeutic orientation among ECT users than with the original concept of a directive-organic orientation.