--- abstract: '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.' altloc: - http://www.ojhas.org/issue45/2013-1-3.html chapter: ~ commentary: ~ commref: ~ confdates: ~ conference: ~ confloc: ~ contact_email: ~ creators_id: - arunag2779@gmail.com - ~ creators_name: - family: Aruna given: G honourific: '' lineage: '' - family: Yadiyal given: MB honourific: '' lineage: '' date: 2013-04-15 date_type: published datestamp: 2014-02-25 12:40:33 department: ~ dir: disk0/00/00/91/37 edit_lock_since: ~ edit_lock_until: 0 edit_lock_user: ~ editors_id: - Kakkilaya BS editors_name: - family: Kakkilaya given: Srinivas honourific: Dr lineage: '' eprint_status: archive eprintid: 9137 fileinfo: /style/images/fileicons/application_pdf.png;/9137/1/2013-1-3.pdf full_text_status: public importid: ~ institution: ~ isbn: ~ ispublished: pub issn: ~ item_issues_comment: [] item_issues_count: ~ item_issues_description: [] item_issues_id: [] item_issues_reported_by: [] item_issues_resolved_by: [] item_issues_status: [] item_issues_timestamp: [] item_issues_type: [] keywords: Modified Electroconvulsive Therapy; Utilization; Trends lastmod: 2014-02-25 12:40:33 latitude: ~ longitude: ~ metadata_visibility: show note: ~ number: 1(3) pagerange: ~ pubdom: TRUE publication: Online Journal of Health and Allied Sciences publisher: Kakkilaya BS refereed: TRUE referencetext: "1.\tAbrams 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.\r\n2.\tAmerican 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.\r\n3.\tNICE. Guidance on the use of ECT. National Institute for clinical excellence, Technology; Appraisal No 59. London, UK. 2003.\r\n4.\tAbrams R. The mortality rate with ECT. Convuls Ther. 1997;13:125-127.\r\n5.\tLeiknes KA, Liny JS, Bjorg H. Contemporary use and practice of ECT worldwide. Brain and Behavior. 2012;2(3):283-345.\r\n6.\tGoswami U, Kumar U, Singh B. Efficacy of ECT in treatment resistant schizophrenia: A double blind study. Indian J Psychiatry. 1986;28:151-154.\r\n7.\tHemphill KE, Walter WG. The treatment of mental disorder by electrically induced convulsions. J. Ment Sci. 1941;87: 256-275.\r\n8.\tUK ECT Review group 2003. Efficacy and safety of ECT in depressive disorder. Systematic review and meta-analysis. The Lancet. 2003;361(9360):799-808.\r\n9.\tRudofer 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.\r\n10.\tRead J, Bentall R. The effectiveness of ECT: a literature review. Epidemiologia e psichiatria sociate. 2010:19(4):333-347.\r\n11.\tTharyan P, Adams CE. Electroconvulsive therapy for schizophrenia. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD000076. DOI: 10.1002/14651858.CD000076.pub2\r\n12.\tKumar S, Jain M, Mohanty S. Effects of ECT in enhancing quality of life in mania. Indian J Psychiatry. 2007;49:35-38.\r\n13.\tRichard CH, Robert AD, ClaudiaWH et al. Variation in ECT use in US. Am J Psychiatry. 1995;152:869-875.\r\n14.\tGirish K. A survey of falling trends in ECT in a mental health trust in UK: Future implications. Indian J Psychiatry. 2007;(49):32-35.\r\n15.\tGangadhar BN, Vivek PH, Jagadisha T. Research on ECT in India: An overview. Indian J Psychiatry. 2010;52(supp/1):362-365.\r\n16.\tKlecha D, Legler M, Hull M. Current use of ECT in the treatment of depressive disorders. Fortschr Neurol Psychiatry. 2001;70 (7):353-367.\r\n17.\tScott AIF. Mode of action of ECT: an update. Advances in Psychiatry Treatment. 2011;17:15-22.\r\n18.\tVersiani 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.\r\n19.\tHussain 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.\r\n20.\tPradic J, Olfson M, Marcus SC et al. Effectiveness of ECT in community settings. Biol Psychiatry. 2004;55:301-312.\r\n21.\tGirish K, Gills NS. ECT in Lorazepam non responsive catatonia. Indian J Psychiatry. 2003:45:21-25.\r\n22.\tTaylor S. ECT: A review of history, patient selection, technique and medication management. South Med J. May 2007;100(5):494-498.\r\n23.\tGreenberg RM, Kellner CH. ECT: a selected review. A J Gesiatr. Psychiatry. 2005;13(4):268-281.\r\n24.\tBeale MD. Kellner CH. ECT in treatment algorithms: no need to save the best for last. J ECT. 2000;16;1-2.\r\n25.\tAgarwal AK, Andrade C, Reddy MV. The Practice of ECT in India. Indian J Psychiatry. 1992;34:285-297.\r\n26.\tLittle JD. ECT in the Asia Pacific region: what do we know? J ECT. 2003;19:93-97.\r\n27.\tChanpattana.W, Kunigiri G, Kramer BA et al. Survey of the Practice of ECT in Teaching hospitals in India. J ECT. 2005;21:100-104.\r\n28.\tAdhikari 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 http://www.kumj.com.np/issue/21/41-48.pdf\r\n29.\tMugisha 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.\r\n30.\tMcCall WV. ECT in the era of modern psychopharmacology. Int. J. Neuropsychop. 2001;4:315-324.\r\n31.\tGazdag G, Kocsis N, Lipcsey A. Rates of ECT use in Hungary in 2002. J. ECT. 2004:20:42-44.\r\n32.\tChung KF, Ng YK, Yiu GC, Cheung HK. ECT in Hong Kong. Psychiatry Bull. 2003;27:102-104.\r\n33.\tChanpattana W. A questionnaire survey of ECT practice in Australia. J ECT. 2007;23;89-92.\r\n34.\tChanpattana W, Kramer BA, Kuerigiri G et al. Survey of practice of ECT in Asia. J ECT. 2010;26:5-140.\r\n35.\tMinistry of health. 2006. ECT annual statistics: for the period of 1 July 2003 to 30 Jun e2005. New Zealand. Available at http://www.health.govt.nz/system/files/documents/publications/electroconvulsive-therapy-annual-statistics.pdf\r\n36.\tRosenbach ML, Hermann RC, Dorward RA. Use of ECT in Medicare population between 1987 and1992. Psychiatry Survey 1997;48:1537-1542.\r\n37.\tHermann RC, Dorward RA, Hoover CW et al. Variation in ECT use in USA. Am J Psychiatry. 1995;152:869-875.\r\n38.\tBertolin Guellin JM, Peivo- Mareno S, Hernandez-de Pablo ME. Patterns of ECT use in Spain. Eur Psychiatry 2006;21:463-470.\r\n39.\tGazdag G, Paliasha D, Hloszewsha I et al. ECT practice in Poland. J. ECT. 2009;25:34-38.\r\n40.\tChanpattana W, Kramer BA. ECT Practice in Thailand. J ECT. 2009;20:94-98.\r\n41.\tFergusson G et al (ed). The Scottish ECT Accreditation network (SEAN) Annual report 2009. Available at http://www.sean.org.uk/SEANReport2009.pdf. Retrieved 2010-05-24.\r\n42.\tTexas Dept of State Health Services. Fy11 Annual Electroconvulsive Therapy (ECT) Summary Reports. Available at http://www.dshs.state.tx.us/WorkArea/linkit.aspx?LinkIdentifier=id&ItemID=8589964105\r\n43.\tMental Health, Drugs and Regions Division, Department of Health, Victorian Government, Melbourne, Victoria. The Chief Psychiatrist’s annual report 2007–08. Available athttp://www.health.vic.gov.au/chiefpsychiatrist/documents/annual_report0809.pdf\r\n44.\tRapoport MJ, Mamdani M, Herrmann N. ECT in older adults: 13- years trends. Can J Psychiatry. 2006;51(9):616-619.\r\n45.\tCiapparelli 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.\r\n46.\tMacedo- 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.\r\n47.\tBharadwaj 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.\r\n48.\tDuffett R, Lelliott P. Auditing ECT. The third cycle. Br J Psychiatry. 1998;172:401-405.\r\n49.\tChanpattana W, Kojina K, Kramer BA et al. ECT Practice in Japan. J. ECT. 2005;21:100-104.\r\n50.\tMotihashi 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.\r\n51.\tJaniacak 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.\r\n52.\tLauber C, Nordt C, Falcato L et al. Can a Seizure help? The Public’s attitude towards ECT. Psychiatry Res. 2005;134(2):205-209.\r\n53.\tArshad 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.\r\n54.\tLauner 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.\r\n55.\tBurstow B. Electroshock as a form of violence against women. Violence against women. 2006;12(4):372-392.\r\n56.\tMc Donald A, Walter G. The portrayal of ECT in American movies. J ECT. 2001;17(4);264-274.\r\n57.\tWalter 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.\r\n58.\tRajagopal 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.\r\n59.\tWennberg JE, Baenes BA, Zibnoff M. Professional uncertainty and Problem of supplier induced demand. Soc Sci Med. 1982;16:811-824.\r\n60.\tCoentre R. ECT: Myths and evidences. Acta Medica Portuguesa. 2009;22(3):275-280.\r\n61.\tFink M. Complaints of loss of personal memories after ECT: evidence of a somatoform disorder? Psychosomatics. 2007;48(4):290-293.\r\n62.\tSackhein HA. Prudic J, Fuller R. The cognitive effects of ECT in community settings. Neuro psychopharmacology. 2007;32(1):244-254.\r\n63.\tBreggin P. ECT changes the brain: disturbing news for patients and shock doctors alike. Ethical Human Psychology and Psychiatry. 2007;9(2):83-86.\r\n64.\tYoussef HA, Youssef FA. Time to abandon ECT as a treatment in modern Psychiatry. Advances in Therapy. 1999;16(1):65-68." relation_type: [] relation_uri: [] reportno: ~ rev_number: 8 series: ~ source: ~ status_changed: 2014-02-25 12:40:33 subjects: - OJHAS succeeds: ~ suggestions: ~ sword_depositor: ~ sword_slug: ~ thesistype: ~ title: 'Is Electroconvulsive Therapy Fading into Oblivion? - A Study of Ten Year Trends' type: journale userid: 4338 volume: 12