ECT on a world map - a narrative review of the use of electroconvulsive therapy and its frequency in the world
DOI:
https://doi.org/10.2478/cpp-2022-0009Keywords:
electroconvulsive therapy, frequency of use, epidemiologyAbstract
Introduction. Since implementation, electroconvulsive therapy has remained very effective treatment in psychiatry. The aim of this study is to present the differences in its use in medical practice around the world. The range of diseases in which ECT is most commonly used and the frequency of its use in different countries were compared with special attention to the differences between highly and poorly developed countries.
Material and method. Review of literature by searching PubMed and Google Scholar databases using the keywords: indications of ECT, frequency of ECT use for papers published from 1991 to 2021.
Results. Among the diseases for which electroconvulsive therapy is used worldwide, major depression dominates, while in Asia and Africa this therapy is used in schizophrenia. In Latin America it is used primarily for schizophrenia and bipolar disorder. In Poland, it is used for depression, bipolar disorder, and fewer for schizophrenia. The highest rate of people treated with therapy per 100,000 population is found in countries such as the USA (51), Canada (23.2-25.6), Australia (37.85), Sweden (41), Finland (23), Slovakia (29.2), Estonia (27.8) and Belgium (47).
Conclusions. There is a relationship between the range of diseases most frequently treated with ECT, the frequency of use and the level of country development. In the high developed countries, ECT is used mainly in major depression, in less developed countries more frequent treatment of schizophrenia may be determined by the high cost of medications and limited availability of hospital beds. The highest rates of use of this therapy are found in more developed countries.
References
1. Kaliora SC, Zervas IM, Papadimitriou GN. Electroconvulsive therapy: 80 years of use in psychiatry. Psychiatr. Psychiatr. 2018;29:291-302.
2. Nasierowski T. Klemens Maleszewski -pionier terapii elektrowstrząsowej w psychiatrii polskiej: odnaleziony w Wilnie rękopis opisu przypadku skutecznego zastosowania prądu galwanicznego u osoby z zespołem katatonicznym (1862), autorstwa Klemensa Maleszewskiego. Polskie Towarzystwo Psychiatryczne; 2002.
3. Aktualności Neurologiczne -Current Neurology [Internet]. [cited 2022 Apr 12]; Available from: http://neurologia.com. pl/index.php/wydawnictwa/2007-vol-7-no-1/sympozjum¬elektrowstrzasy-zabiegi-elektrowstrzasowe
4. Antosik-Wójcińska AZ, Święcicki Ł. Terapia elektrowstrząsowa - skuteczna i bezpieczna alternatywa dla nieskutecznej farmakoterapii. Psychiatria 2014;11:166-70.
5. Ishihara K, Sasa M. Mechanism underlying the therapeutic effects of electroconvulsive therapy (ECT) on depression. Jpn. J. Pharmacol. 1999;80:185-9.
6. Scott AIF. The ECT Handbook: The Third Report of the Royal College of Psychiatrists’ Special Committee on ECT. RCPsych Publications; 2005.
7. Zyss T, Hese RT, Zięba A. Terapia wstrząsowa w psychiatrii : rys historyczny. Psychiatr. Pol. [Internet] 2008 [cited 2022 Apr 12];42. Available from: https://ruj.uj.edu.pl/xmlui/handle/ item/158623
8. Psychiatria Polska -46, 3 [Internet]. [cited 2022 Apr 12]; Available from: http://www.psychiatriapolska.pl/46-3.html
9. Lyden H, Espinoza RT, Pirnia T, Clark K, Joshi SH, Leaver AM, et al. Electroconvulsive therapy mediates neuroplasticity of white matter microstructure in major depression. Transl. Psychiatry 2014;4:e380-e380.
10. Standardy farmakologicznego leczenia chorób afektywnych [Internet]. [cited 2022 Jul 13]. Available from: http://www.fpn.ipin.edu.pl/archiwum/2011-zeszyt-3-4/st andardy-farmakologicznego-leczenia-chorob-afektywnych.html
11. Antosik-Wojcinska A, Swiecicki Ł, Chorób O, Ipin A. Analiza skuteczności i bezpieczeństwa zabiegów elektrowstrząsowych w populacjach przed i po 60. roku życia The efficacy and safety of ECT in population before and after 60 years of age. Psychiatr. Pol. 2016;50:1015-26.
12. Analiza retrospektywna skuteczności terapii elektrowstrząsami w depresji lekoopornej [Internet]. [cited 2022 Jul 13]; Available from: https://9lib.org/document/7qvd50gq-analiza-retrospektywna-skuteczno%C5%9Bci-terapii¬elektrowstrz%C4%85sami-w-depresji-lekoopornej.html
13. Analiza kliniczna skuteczności i bezpieczeństwa leczenia -[PDF Document] [Internet]. fdocuments.net [cited 2022 Jul 13]; Available from: https://fdocuments.net/document/analiza¬kliniczna-skutecznosci-i-bezpieczenstwa-leczenia-.html
14. Gazdag G, Dragasek J, Takács R, Lõokene M, Sobow T, Olekseev A, et al. Use of Electroconvulsive Therapy in Central-Eastern European Countries: an Overview. Psychiatr. Danub. 2017;29:136-40.
15. Martin BA, Delva NJ, Graf P, Gosselin C, Enns MW, Gilron I, et al. Delivery of Electroconvulsive Therapy in Canada: A First National Survey Report on Usage, Treatment Practice, and Facilities. J. ECT 2015;31:119-24.
16. Hermann RC, Dorwart RA, Hoover CW, Brody J. Variation in ECT use in the United States. Am. J. Psychiatry 1995;152:869-75.
17. Zyss T. Kontrowersje i uwagi krytyczne dotyczące terapii elektrowstrząsowej. Psychiatria 2010;7:38-45.
18. Kaster TS, Blumberger DM, Gomes T, Sutradhar R, Dasklakis ZJ, Wijeysundera DN, et al. Patient-level Characteristics and Inequitable Access to Inpatient Electroconvulsive Therapy for Depression: A Population-based Cross-sectional Study: Caractéristiques au niveau du patient et accès inéquitable à la thérapie électroconvulsive pour patients hospitalisés. Can. J. Psychiatry 2021;66:147-58.
19. Milev RV, Giacobbe P, Kennedy SH, Blumberger DM, Daskalakis ZJ, Downar J, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 4. Neurostimulation Treatments. Can. J. Psychiatry 2016;61:561-75.
20. Plakiotis C, George K, O’Connor DW. Has electroconvulsive therapy use remained stable over time? A decade of electroconvulsive therapy service provision in Victoria, Australia. Aust. N. Z. J. Psychiatry 2012;46:522-31.
21. Chanpattana W. A questionnaire survey of ECT practice in Australia. J. ECT 2007;23:89-92.
22. Martin DM, Gálvez V, Lauf S, Dong V, Baily SA, Cardoner N, et al. The Clinical Alliance and Research in Electroconvulsive Therapy Network: An Australian Initiative for Improving Service Delivery of Electroconvulsive Therapy. J. ECT 2018;34:7-13.
23. Malhi GS, Bell E, Boyce P, Bassett D, Berk M, Bryant R, et al. The 2020 Royal Australian and New Zealand College of psychiatrists clinical practice guidelines for mood disorders: Bipolar disorder summary. Bipolar Disord. 2020;22:805-21.
24. Sumia P, Seppälä N, Ritschkoff J, Tammentie-Sarèn T, Leinonen E, Järventausta K. A Survey of Electroconvulsive Therapy in Finland. J. ECT 2021;37:36-9.
25. Schweder LJ von, Wahlund B, Bergsholm P, Linaker OM. Questionnaire Study About the Practice of Electroconvulsive Therapy in Norway. J. ECT 2011;27:296-9.
26. Schweder LJ von, Lydersen S, Wahlund B, Bergsholm P, Linaker OM. Electroconvulsive therapy in Norway: rates of use, clinical characteristics, diagnoses, and attitude. J. ECT 2011;27:292-5.
27. Nordanskog P, Hultén M, Landén M, Lundberg J, von Knorring L, Nordenskjöld A. Electroconvulsive Therapy in Sweden 2013. J. Ect 2015;31:263-7.
28. Popiolek K, Bejerot S, Brus O, Hammar Å, Landén M, Lundberg J, et al. Electroconvulsive therapy in bipolar depression - effectiveness and prognostic factors. Acta Psychiatr. Scand. 2019;140:196-204.
29. Hundrup E, Osler M, Jørgensen MB. Time Trends and Variations in Electroconvulsive Treatment in Denmark 2008 to 2014: A Nationwide Register-Based Study. J. ECT 2017;33:243-8.
30. Leiknes KA, Jarosh-von Schweder L, Høie B. Contemporary use and practice of electroconvulsive therapy worldwide. Brain Behav. 2012;2:283-344.
31. Gazdag G, Kocsis N, Tolna J, Lipcsey A. Attitudes towards electroconvulsive therapy among Hungarian psychiatrists. J. ECT 2004;20:204-7.
32. Saatcioglu O, Tomruk NB. Practice of electroconvulsive therapy at the research and training hospital in Turkey. Soc. Psychiatry Psychiatr. Epidemiol. 2008;43:673-7.
33. Lõokene M, Kisuro A, Mačiulis V, Banaitis V, Ungvari GS, Gazdag G. Use of electroconvulsive therapy in the Baltic states. World J. Biol. Psychiatry Off. J. World Fed. Soc. Biol. Psychiatry 2014;15:419-24.
34. Kleinberg A, Aluoja A, Vasar V. Point prevalence of major depression in Estonia. Results from the 2006 Estonian Health Survey. Eur. Psychiatry J. Assoc. Eur. Psychiatr. 2010;25:485-90.
35. Gazdag G, Takács R, Ungvari GS, Sienaert P. The practice of consenting to electroconvulsive therapy in the European Union. J. ECT 2012;28:4-6.
36. Mukherjee S, Sackeim HA, Schnur DB. Electroconvulsive therapy of acute manic episodes: a review of 50 years’ experience. Am. J. Psychiatry 1994;151:169-76.
37. Petrides G, Tobias KG, Kellner CH, Rudorfer MV. Continuation and maintenance electroconvulsive therapy for mood disorders: review of the literature. Neuropsychobiology 2011;64:129-40.
38. Sartorius A, Henn FA. Erhaltungs-EKT. Psychiatr. Prax. 2005;32:408-11.
39. Sienaert P, Dierick M, Degraeve G, Peuskens J. Electroconvulsive therapy in Belgium: a nationwide survey on the practice of electroconvulsive therapy. J. Affect. Disord. 2006;90:67-71.
40. Sienaert P, Falconieri T, Obbels J, van den Ameele H, Bouckaert F. Improving Practice in Electroconvulsive Therapy: A Nationwide Survey in Belgium. J. ECT 2016;32:29-32.
41. Antosik-Wójcińska AZ, Dominiak M, Mierzejewski P, Jażdżyk P, Gazdag G, Takacs R, et al. Changes in the Practice of Electroconvulsive Therapy in Poland: A Nationwide Survey Comparing Data Between 2005 and 2020. Neuropsychiatr. Dis. Treat. 2021;17:605-12.
42. Antosik-Wójcińska AZ, Poleszczyk A. Electroconvulsive therapy a pocket guide for family doctors. Fam. Med. Prim. Care Rev. 2015;17:280-3.
43. Chanpattana W, Kramer BA, Kunigiri G, Gangadhar BN, Kitphati R, Andrade C. A Survey of the Practice of Electroconvulsive Therapy in Asia. J. ECT 2010;26:5-10.
44. Xiang YT, Ungvari GS, Correll CU, Chiu HFK, Lai KYC, Wang CY, et al. Use of electroconvulsive therapy for Asian patients with schizophrenia (2001-2009): Trends and correlates. Psychiatry Clin. Neurosci. 2015;69:489-96.
45. Tor PC, Gálvez V, Ang A, Fam J, Chan HN, Tan SN, et al. Electroconvulsive practice in Singapore: a cross-sectional national survey. Singapore Med. J. 2019;60:590-5.
46. Chanpattana W, Kojima K, Kramer BA, Intakorn A, Sasaki S, Kitphati R. ECT practice in Japan. J. ECT 2005;21:139-44.
47. Chanpattana W, Kunigiri G, Kramer BA, Gangadhar BN. Survey of the practice of electroconvulsive therapy in teaching hospitals in India. J. ECT 2005;21:100-4.
48. Grover S, Malhotra S, Varma S, Chakrabarti S, Avasthi A, Mattoo SK. Electroconvulsive therapy in adolescents: a retrospective study from north India. J. ECT 2013;29:122-6.
49. Chanpattana W, Kramer BA. Electroconvulsive therapy practice in Thailand. J. ECT 2004;20:94-8.
50. Ittasakul P, Vora-arporn S, Waleeprakhon P, Tor PC. Number of Electroconvulsive Therapy Sessions required for Thai Psychiatric Patients: a Retrospective Study. Neuropsychiatr. Dis. Treat. 2020;Volume 16:673-9.
51. Zhang XQ, Wang ZM, Pan YL, Chiu HFK, Ng CH, Ungvari G, et al. Use of electroconvulsive therapy in older Chinese psychiatric patients. Int. J. Geriatr. Psychiatry 2015;30:851-6.
52. Wang ZM, Zhu H, Pan YL, Chiu HFK, Correll CU, Ungvari GS, et al. Electroconvulsive therapy and its association with demographic and clinical characteristics in Chinese psychiatric patients. J. ECT 2015;31:114-8.
53. Zhang QE, Wang ZM, Sha S, Ng CH, Seiner SJ, Welch CA, et al. Common Use of Electroconvulsive Therapy for Chinese Adolescent Psychiatric Patients. J. ECT 2016;32:251-5.
54. Chung KF. Electroconvulsive Therapy in Hong Kong: Rates of Use, Indications, and Outcome. J. ECT 2003;19:98-102.
55. Nelson AI. A National Survey of Electroconvulsive Therapy Use in the Russian Federation. J. ECT 2005;21:151-7.
56. Chanpattana W, Kramer BA, Kunigiri G, Gangadhar BN, Kitphati R, Andrade C. A Survey of the Practice of Electroconvulsive Therapy in Asia. J. ECT 2010;26:5-10.
57. James BO, Inogbo CF. Implementing Modified Electroconvulsive Therapy in Nigeria: Current Status and Psychiatrists’ Attitudes. J. ECT 2013;29:e25-6.
58. Mugisha RX, Ovuga EB. The use of electroconvulsive therapy in the treatment of psychiatric illness at Umzimkulu Hospital in Transkei. A retrospective study. South Afr. Med. J. Suid-Afr. Tydskr. Vir Geneeskd. 1991;79:391-3.
59. Benson-Martin JJ, Milligan PD. A Survey of the Practice of Electroconvulsive Therapy in South Africa. J. ECT 2015;31:253-7.
60. Swartz CM. Electroconvulsive and Neuromodulation Therapies. Cambridge University Press; 2009.
61. Soda T, McLoughlin DM, Clark SR, Oltedal L, Kessler U, Haavik J, et al. International Consortium on the Genetics of Electroconvulsive Therapy and Severe Depressive Disorders (Gen-ECT-ic). Eur. Arch. Psychiatry Clin. Neurosci. 2020;270:921-32.
62. Case BG, Bertollo DN, Laska EM, Price LH, Siegel CE, Olfson M, et al. Declining use of electroconvulsive therapy in United States general hospitals. Biol. Psychiatry 2013;73:119-26.
63. LLC ESC& M. Health Care [Internet]. Eckert Seam. [cited 2022 Apr 11];Available from: https://www.eckertseamans.com/our¬practices/health-care
64. Reid WH, Keller S, Leatherman M, Mason M. ECT in Texas: 19 months of mandatory reporting. J. Clin. Psychiatry 1998;59:8- 13.
65. Prudic J, Olfson M, Sackeim HA. Electro-convulsive therapy practices in the community. Psychol. Med. 2001;31:929-34.
66. Delivery of Electroconvulsive Therapy in Non-Hospital Settings: A Review of the Safety and Guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2014 [cited 2022 Apr 11]. Available from: http://www.ncbi.nlm.nih. gov/books/NBK263408/
67. Lemasson M, Haesebaert J, Rochette L, Pelletier E, Lesage A, Patry S. Electroconvulsive Therapy Practice in the Province of Quebec: Linked Health Administrative Data Study from 1996 to 2013. Can. J. Psychiatry Rev. Can. Psychiatr. 2018;63:465-73.
68. Delva NJ, Graf P, Patry S, Gosselin C, Milev R, Gilron I, et al. Access to Electroconvulsive Therapy Services in Canada. J. ECT 2011;27:300-9.
69. Wood DA, Wood DA, Burgess PM. Epidemiological Analysis of Electroconvulsive Therapy in Victoria, Australia. Aust. N. Z. J. Psychiatry 2003;37:307-11.
70. Hranov LG, Hranov G, Ungvari GS, Gazdag G. Electroconvulsive therapy in Bulgaria: a snapshot of past and present. J. ECT 2012;28:108-10.
71. Spiric Z, Stojanovic Z, Samardzic R, Milovanovi S, Gazdag G, Mari NP. Electroconvulsive Therapy Practice In Serbia Today. 26:4.
72. Olekseev A, Ungvari GS, Gazdag G. Electroconvulsive Therapy Practice in Ukraine. J. ECT 2014;30:216-9.
73. Overview | Guidance on the use of electroconvulsive therapy | Guidance | NICE [Internet]. [cited 2022 Apr 11];Available from: https://www.nice.org.uk/guidance/ta59
74. Rose DS, Wykes TH, Bindman JP, Fleischmann PS. Information, consent and perceived coercion: patients’ perspectives on electroconvulsive therapy. Br. J. Psychiatry J. Ment. Sci. 2005;186:54-9.
75. Li Q, Su YA, Xiang YT, Shu L, Yu X, Ungvari GS, et al. Electroconvulsive Therapy in Schizophrenia in China: A National Survey. J. ECT 2017;33:138-42.
76. Chu CW, Chien WC, Chung CH, Chao PC, Chang HA, Kao YC, et al. Electroconvulsive Therapy and Risk of Dementia—A Nationwide Cohort Study in Taiwan. Front. Psychiatry [Internet] 2018 [cited 2022 Apr 11];9. Available from: https://www.frontiersin.org/article/10.3389/fpsyt.2018.00397
77. Bertolín-Guillén JM, Peiró-Moreno S, Hernández-de-Pablo ME. Patterns of electroconvulsive therapy use in Spain. Eur. Psychiatry J. Assoc. Eur. Psychiatr. 2006;21:463-70.
78. Levav I, González Uzcátegui R. The use of electroconvulsive therapy in Latin America and the Caribbean. Rev. Panam. Salud Pública 1998;3:121-3.
79. Melzer-Ribeiro D, Rigonatti S, Cordeiro Q. Electroconvulsive Therapy in Brazil After the ‘Psychiatric Reform’ A Public Health Problem-Example From a University Service. J. ECT 2012;28:170-3.
80. Folkerts HW. [Electroconvulsive therapy. Indications, procedure and treatment results]. Nervenarzt 2011;82:93-102, quiz 103.
81. www.medforum.com.pl MS z o o-. Leczenie elektrowstrząsowe w Polsce [UPDATE] | Aktualności [Internet]. Pol. Tow. Psychiatryczne [cited 2022 Jul 7];Available from: https://psychiatria.org.pl/news,tekst,397,leczenie_elektrowstrzasowe_w_polsce_update_
82. Kaster TS, Blumberger DM, Gomes T, Sutradhar R, Dasklakis ZJ, Wijeysundera DN, et al. Patient-level Characteristics and Inequitable Access to Inpatient Electroconvulsive Therapy for Depression: A Population-based Cross-sectional Study: Caractéristiques au niveau du patient et accès inéquitable à la thérapie électroconvulsive pour patients hospitalisés. Can. J. Psychiatry 2021;66:147-58.
83. Lima NN, Nascimento VB, Peixoto JA, Moreira MM, Neto ML, Almeida JC, et al. Electroconvulsive therapy use in adolescents: a systematic review. Ann. Gen. Psychiatry 2013;12:17.
84. Richards EM, Payne JL. The management of mood disorders in pregnancy: alternatives to antidepressants. CNS Spectr. 2013;18:261-71.
85. Martin BA, Delva NJ, Graf P, Gosselin C, Enns MW, Gilron I, et al. Delivery of Electroconvulsive Therapy in Canada: A First National Survey Report on Usage, Treatment Practice, and Facilities. J. ECT 2015;31:119-24.
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Authors
This work is licensed under a Creative Commons Attribution 4.0 International License.
