Is Electroconvulsive Therapy Fading into Oblivion? - A Study of Ten Year Trends

Aruna, G and Yadiyal, MB (2013) Is Electroconvulsive Therapy Fading into Oblivion? - A Study of Ten Year Trends. [Journal (On-line/Unpaginated)]

Full text available as:

PDF - Published Version
Available under License Creative Commons Attribution No Derivatives.



Background: Despite proven efficacy, modified ECT has been variably used in the recent past, with data on the usage trend being scarce, worldwide. Aim: We aimed to do a time – series analysis to examine annual trends in modified ECT use in our tertiary teaching hospital in the last decade. Methods: A chart review was carried out on all patients who received m-ECT in our teaching hospital in the last ten years (2002 to 2011), and percentage of total inpatients receiving M-ECT each year was deduced. Along with number of ECT sessions given per year, details of demographic data, and indications for ECT were recorded. Results: In our study ECT was undersized as a treatment option, with only 1:13% of total inpatients having received ECT. Also it was noted that use began increasing from 2002, reaching a peak in 2006 (84% increase) followed by a downward trend, with a sharp decline since 2008 (61%decrease) and finally reaching a nadir in 2011 (69% decrease). Mean age of patients ranged from 31.28 to 40.1 years with a slightly high female preponderance in most year groups. The most common indication for ECT use was schizophrenia (47.8%) followed by, depression (38.9%). Conclusion: Although, our study finding is in line with the downward trend of ECT utilization rates reported worldwide, the nature and magnitude of decline cannot be explained nor compared globally due to variations, inaccuracies and heterogeneity of ECT data currently available. Further, factors responsible for such trends should become focus of future research.

Item Type:Journal (On-line/Unpaginated)
Keywords:Modified Electroconvulsive Therapy; Utilization; Trends
Subjects:JOURNALS > Online Journal of Health and Allied Sciences
ID Code:9137
Deposited By: Kakkilaya Bevinje, Dr. Srinivas
Deposited On:25 Feb 2014 12:40
Last Modified:25 Feb 2014 12:40

References in Article

Select the SEEK icon to attempt to find the referenced article. If it does not appear to be in cogprints you will be forwarded to the paracite service. Poorly formated references will probably not work.

1. Abrams R. History of ECT and efficacy of ECT. In Abrams R. (Editor) Electroconvulsive Therapy. 4th Edition. Oxford University Press, New York. 2002. pp: 3-43.

2. American Psychiatric Association Task Force on Electroconvulsive Therapy. The Practice of ECT: Recommendation for treatment, training and privileging, task force Report on ECT. 2nd Edition. APA, Washington DC. 2001.

3. NICE. Guidance on the use of ECT. National Institute for clinical excellence, Technology; Appraisal No 59. London, UK. 2003.

4. Abrams R. The mortality rate with ECT. Convuls Ther. 1997;13:125-127.

5. Leiknes KA, Liny JS, Bjorg H. Contemporary use and practice of ECT worldwide. Brain and Behavior. 2012;2(3):283-345.

6. Goswami U, Kumar U, Singh B. Efficacy of ECT in treatment resistant schizophrenia: A double blind study. Indian J Psychiatry. 1986;28:151-154.

7. Hemphill KE, Walter WG. The treatment of mental disorder by electrically induced convulsions. J. Ment Sci. 1941;87: 256-275.

8. UK ECT Review group 2003. Efficacy and safety of ECT in depressive disorder. Systematic review and meta-analysis. The Lancet. 2003;361(9360):799-808.

9. Rudofer MV, Henry ME, Sacheion HA. Electroconvulsive Therapy. In Tasman A, Kay T, Lieberman JA.(editors). Organic Psychaitry. 2nd edition. John Wiley and Sons Ltd, Chichester. 2003. PP 1865-1901.

10. Read J, Bentall R. The effectiveness of ECT: a literature review. Epidemiologia e psichiatria sociate. 2010:19(4):333-347.

11. Tharyan P, Adams CE. Electroconvulsive therapy for schizophrenia. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD000076. DOI: 10.1002/14651858.CD000076.pub2

12. Kumar S, Jain M, Mohanty S. Effects of ECT in enhancing quality of life in mania. Indian J Psychiatry. 2007;49:35-38.

13. Richard CH, Robert AD, ClaudiaWH et al. Variation in ECT use in US. Am J Psychiatry. 1995;152:869-875.

14. Girish K. A survey of falling trends in ECT in a mental health trust in UK: Future implications. Indian J Psychiatry. 2007;(49):32-35.

15. Gangadhar BN, Vivek PH, Jagadisha T. Research on ECT in India: An overview. Indian J Psychiatry. 2010;52(supp/1):362-365.

16. Klecha D, Legler M, Hull M. Current use of ECT in the treatment of depressive disorders. Fortschr Neurol Psychiatry. 2001;70 (7):353-367.

17. Scott AIF. Mode of action of ECT: an update. Advances in Psychiatry Treatment. 2011;17:15-22.

18. Versiani M, Cheniaux E, Landeira- Fernandez J. Efficacy and safety of ECT in the treatment of bipolar disorder: A systematic review. J ECT. 2011;27:153-164.

19. Hussain MM, Rush AJ, Fink M et al. Speed of response and remission in MDD with ECT. A consortium of research on ECT (CORE) report. J Clin Psychiatry. 2004;65:485-491.

20. Pradic J, Olfson M, Marcus SC et al. Effectiveness of ECT in community settings. Biol Psychiatry. 2004;55:301-312.

21. Girish K, Gills NS. ECT in Lorazepam non responsive catatonia. Indian J Psychiatry. 2003:45:21-25.

22. Taylor S. ECT: A review of history, patient selection, technique and medication management. South Med J. May 2007;100(5):494-498.

23. Greenberg RM, Kellner CH. ECT: a selected review. A J Gesiatr. Psychiatry. 2005;13(4):268-281.

24. Beale MD. Kellner CH. ECT in treatment algorithms: no need to save the best for last. J ECT. 2000;16;1-2.

25. Agarwal AK, Andrade C, Reddy MV. The Practice of ECT in India. Indian J Psychiatry. 1992;34:285-297.

26. Little JD. ECT in the Asia Pacific region: what do we know? J ECT. 2003;19:93-97.

27. Chanpattana.W, Kunigiri G, Kramer BA et al. Survey of the Practice of ECT in Teaching hospitals in India. J ECT. 2005;21:100-104.

28. Adhikari SR, Pradhan SN, Sharma SC et al. Diagnostic variability and therapeutic efficacy of ECT in Nepalese sample. Kathmandu Univ Med J. 2008;6:41-48. Available at

29. Mugisha RX, Ovuga EB. The use of ECT in treatment of Psychiatric illness at Umzimkulu hospital in Transkel: A retrospective study. South Afr. Med J. 1991;79:391-393.

30. McCall WV. ECT in the era of modern psychopharmacology. Int. J. Neuropsychop. 2001;4:315-324.

31. Gazdag G, Kocsis N, Lipcsey A. Rates of ECT use in Hungary in 2002. J. ECT. 2004:20:42-44.

32. Chung KF, Ng YK, Yiu GC, Cheung HK. ECT in Hong Kong. Psychiatry Bull. 2003;27:102-104.

33. Chanpattana W. A questionnaire survey of ECT practice in Australia. J ECT. 2007;23;89-92.

34. Chanpattana W, Kramer BA, Kuerigiri G et al. Survey of practice of ECT in Asia. J ECT. 2010;26:5-140.

35. Ministry of health. 2006. ECT annual statistics: for the period of 1 July 2003 to 30 Jun e2005. New Zealand. Available at

36. Rosenbach ML, Hermann RC, Dorward RA. Use of ECT in Medicare population between 1987 and1992. Psychiatry Survey 1997;48:1537-1542.

37. Hermann RC, Dorward RA, Hoover CW et al. Variation in ECT use in USA. Am J Psychiatry. 1995;152:869-875.

38. Bertolin Guellin JM, Peivo- Mareno S, Hernandez-de Pablo ME. Patterns of ECT use in Spain. Eur Psychiatry 2006;21:463-470.

39. Gazdag G, Paliasha D, Hloszewsha I et al. ECT practice in Poland. J. ECT. 2009;25:34-38.

40. Chanpattana W, Kramer BA. ECT Practice in Thailand. J ECT. 2009;20:94-98.

41. Fergusson G et al (ed). The Scottish ECT Accreditation network (SEAN) Annual report 2009. Available at Retrieved 2010-05-24.

42. Texas Dept of State Health Services. Fy11 Annual Electroconvulsive Therapy (ECT) Summary Reports. Available at

43. Mental Health, Drugs and Regions Division, Department of Health, Victorian Government, Melbourne, Victoria. The Chief Psychiatrist’s annual report 2007–08. Available at

44. Rapoport MJ, Mamdani M, Herrmann N. ECT in older adults: 13- years trends. Can J Psychiatry. 2006;51(9):616-619.

45. Ciapparelli A, Dell’osso L, Tundo A et al. ECT in medication non responsive patients with mixed mania and bipolar depression. J Clin Psychiatry. 2011;62:552-555.

46. Macedo- Soares MB, Moreno RA, Rigonatti ST. et al. Efficacy of ECT in treatment – resistant bipolar disorder. A case series. J ECT 2005;21:31-34.

47. Bharadwaj V, Grover S, Chakrabarthi S et al. Clinical profile and outcome of bipolar disorder patients receiving ECT: A study from North India. Indian .J. Psychiatry. 2012;54(1):41-47.

48. Duffett R, Lelliott P. Auditing ECT. The third cycle. Br J Psychiatry. 1998;172:401-405.

49. Chanpattana W, Kojina K, Kramer BA et al. ECT Practice in Japan. J. ECT. 2005;21:100-104.

50. Motihashi N, Awata S, Higuchi T. A questionnaire survey of ECT practice in university hospitals and national hospitals sin Japan. J. ECT. 2004;20:21-23.

51. Janiacak PG, Mash J, Trimakas KA et al ECT: An assessment of mental health professional’s knowledge and attitude. J Clin Psychiatry. 1985;546:262-266.

52. Lauber C, Nordt C, Falcato L et al. Can a Seizure help? The Public’s attitude towards ECT. Psychiatry Res. 2005;134(2):205-209.

53. Arshad M, Arham AZ, Arif M et al. Awareness & perceptions of ECT among psychiatry patients: a cross sectional survey from teaching hospitals in Karachi, Pakistan. BMC Psychiatry. 2007;7:27-29.

54. Launer C, Nordt C, Roster W. Recommendations of mental health professionals and the general population on how to treat mental disorders. Soc Psychiatry Psychiatric Epidemiol. 2005;40(10):835-843.

55. Burstow B. Electroshock as a form of violence against women. Violence against women. 2006;12(4):372-392.

56. Mc Donald A, Walter G. The portrayal of ECT in American movies. J ECT. 2001;17(4);264-274.

57. Walter G, Mc Donald A, Rey JM et al .Medical student’s knowledge and attitude regarding ECT prior to and after viewing ECT scenes from movies. J ECT. 2002;18:43-46.

58. Rajagopal R, Chahrabarti S, Grover S et al. Knowledge, experience and attitudes concerning ECT among patients and relatives. Indian J Med Res. 2012;135:201-210.

59. Wennberg JE, Baenes BA, Zibnoff M. Professional uncertainty and Problem of supplier induced demand. Soc Sci Med. 1982;16:811-824.

60. Coentre R. ECT: Myths and evidences. Acta Medica Portuguesa. 2009;22(3):275-280.

61. Fink M. Complaints of loss of personal memories after ECT: evidence of a somatoform disorder? Psychosomatics. 2007;48(4):290-293.

62. Sackhein HA. Prudic J, Fuller R. The cognitive effects of ECT in community settings. Neuro psychopharmacology. 2007;32(1):244-254.

63. Breggin P. ECT changes the brain: disturbing news for patients and shock doctors alike. Ethical Human Psychology and Psychiatry. 2007;9(2):83-86.

64. Youssef HA, Youssef FA. Time to abandon ECT as a treatment in modern Psychiatry. Advances in Therapy. 1999;16(1):65-68.


Repository Staff Only: item control page