Use of Electroconvulsive Therapy in a State Hospital: A 10-Year Review
J Clin Psychiatry 2000;61(7):534-539
© Copyright 2015 Physicians Postgraduate Press, Inc.
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Background: The use of electroconvulsive therapy
(ECT) in the state hospital setting currently represents a very
small percentage of the total overall use of this modality in the
treatment of the mentally ill.
Method: Using records kept by a state hospital,
we retrospectively identified all patients who had received ECT
between the years 1986 and 1995. A review of the records at the
state hospital from where patients were referred and the
university hospital where ECT was administered was undertaken.
Demographic and clinical characteristics, reasons for referral,
symptom profile, ECT parameters, clinical outcomes, and
restraint/seclusion data were assessed.
Results: Over 10 years, 21 patients were treated
with ECT, representing 0.4% of all admissions to the state
hospital. Of these subjects, 17 records could be retrieved. The
majority were women (N = 12; 71%) and were diagnosed with a mood
disorder. Ten subjects (59%) were over the age of 60 years, 4 of
whom were 70 years or older. Most patients had a state hospital
length of stay of 1 year or less. The mean number of ECT
treatments was 12.2. There were no medical complications that led
to premature termination of ECT. Eleven patients (65%) were
discharged either directly from the university hospital or within
10 days of readmission to the state hospital. Six of 7 patients
who had restraint and seclusion episodes prior to ECT were found
to have no further episodes afterwards. The seventh experienced a
dramatic decrease in number and total hours of episodes.
Conclusion: For a substantial minority of
patients in this state hospital setting, ECT appears to have been
an effective and safe form of treatment, and its use should be
considered early rather than late in the course of