Trends and Age-Stratified Analysis of Electroconvulsive Therapy Utilization in Japan

Objectives: The status of electroconvulsive therapy (ECT) in Japan is unknown on a nationwide scale. This study aims to elucidate the use of ECT utilizing a Japanese nationwide receipt database. Methods: The annual average number of ECT sessions per 100,000 people in Japan between 2014 and 2021 was evaluated by stratifying the population into sex and age groups. ECT was further broken down into management type (outpatient or inpatient) and anesthesia methodology (general or non-general). We analyzed the distribution peak patterns of the age-stratified data. Annual trends were evaluated using the Jonckheere–Terpstra trend test or Poisson regression model. Results: Over the 8-year period, the overall ECT administration amounted to 700,621 sessions, translating to a rate of 69.2 sessions per 100,000 person-years. The men-to-women ratio was 1:1.4, indicating slight women predominance. The age-stratified data fluctuated greatly from year to year, except for inpatient ECT under general anesthesia (iECT-GA), which remained stable. Peak analysis of the iECT-GA indicated that the maximum peak was observed in men aged 50 to 59 years and women aged 70 to 74 years. Conclusions: Considering that a typical ECT course consists of 6 to 12 sessions, the average number of patients undergoing ECT is estimated to be 5.8 to 11.5 per 100,000 person-years. A demographic peak of the iECT-GA was observed in men in their 50s and early 70s for women, suggesting distinct sex-specific patterns. This preliminary study provides an overview of the ECT use in Japan, representing one of the nations in Asia.