Change in the Use of Electroconvulsive Therapy Between 2012 and 2022 in Northern Finland

Objectives: The demand for Electroconvulsive Therapy (ECT) has been increasing. The aim of this study was to analyze changes in the rate of ECT use at Oulu University Hospital in Northern Finland from 2012 to 2022 and to explore factors associated with these changes. Methods: The data include all patients who received ECT between April 2012 and the end of 2022 at the neuromodulation unit in the department of psychiatry at Oulu University Hospital. The unit’s catchment area covers a population of 484,400 people. The study focuses on the annual number of ECT and maintenance ECT (M-ECT) sessions, the ECT use rate per 100,000 people, and the number of individual patients and their characteristics, with a focus on yearly changes. Results: The number of ECT sessions has increased significantly during the follow-up period. There were 1373 ECT sessions in the first full year of 2013 and 3000 sessions in 2022. The growth was particularly notable in M-ECT. ECT was performed on 96 unique patients in 2013 and 189 in 2022. The ECT use rate in 2022 was 45.7 per 100,000 population. 54.6% of the patients were female. The most common diagnosis was major nonpsychotic depression (45.9%). Conclusions: The results show a steady increase in the demand for ECT. The use rate in Northern Finland is higher than in the previous Finnish study and among the highest in Europe. Improved strategies to prevent post-ECT relapses and alternative treatment methods for treatment-resistant depression (TRD) are needed.