Background: The use of electroconvulsive therapy (ECT) in the state hospita
l 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 identifi
ed all patients who had received ECT between the years 1986 and 1995. A rev
iew of the records at the state hospital from where patients were referred
and the university hospital where ECT was administered was undertaken. Demo
graphic and clinical characteristics, reasons for referral, symptom profile
, ECT parameters, clinical outcomes, and restraint/seclusion data were asse
ssed.
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 co
uld 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 o
f 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. Ele
ven patients (65%) were discharged either directly from the university hosp
ital or within 10 days of readmission to the state hospital. Six of 7 patie
nts who had restraint and seclusion episodes prior to ECT were found to hav
e no further episodes afterwards. The seventh experienced a dramatic decrea
se in number and total hours of episodes.
Conclusion: For a substantial minority of patients in this state hospital s
etting, ECT appears to have been an effective and safe form of treatment, a
nd its use should be considered early rather than late in the course of hos
pitalization.