Old age psychiatrists' views on the use of ECT

Two hundred and five practising old age psychiatrists completed a questionnaire regarding their opinions and use of electroconvulsive therapy (ECT). Details of the psychiatrists and their jobs were recorded, their opinions were sought on ECT and they were asked their views regarding physical problems in association with treatment, as well as the treatment procedure they employed. The majority of respondents reported that they would consider using ECT for appropriate patients, but opinion diverged concerning who this might be. Agreement was greatest regarding when ECT would never be appropriate. Depressive psychosis was the condition where ECT was felt most often to be useful. Most respondents used bilateral ECT, and most commonly administered it twice weekly. There was broad agreement over when ECT might be the treatment of choice and whether certain psychotropic drugs should be discontinued during treatment. All respondents regarded physical examination as routinely necessary prior to treatment, but opinion diverged regarding other investigations. Similarly, views diverged regarding which physical conditions might constitute absolute or partial contraindications to ECT. ECT is regarded as useful by most old age psychiatrists, and age itself is not a contraindication to treatment.