ECT in Wales is primarily utilized for patients with affective disorders who have failed to respond adequately to pharmacological treatments, yielding high rates of clinical improvement.
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ECT use in refractory affective disorders yields high short-term improvement; cross-sectional data leaves open causal efficacy and optimal selection.
Aims and method The use of electroconvulsive therapy (ECT) was surveyed over the first six months of 1996 in Wales. Data on the indications for ECT and clinical outcome were collected in the first three months. Results The computed annual rate was 22 patients treated with ECT per 100 000 population. Women constituted 71% of those receiving ECT (236/321). Eighty-three per cent had an affective disorder, and 80% had failed to respond to previous treatments. Only 33% of patients had been prescribed more than one class of antidepressant and only 25% had received augmentation with lithium or an alternative drug before being given ECT. Clinical implications ECT is mostly used after a failure of patients to respond adequately to a course of antidepressants.
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Duffett et al. (1999) studied this question.
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