Electroconvulsive Therapy at a Veterans Health Administration Medical Center

J ECT. 2017 Dec;33(4):249-252. doi: 10.1097/YCT.0000000000000400.

Abstract

Objectives: Little epidemiologic research has examined the practice of electroconvulsive therapy (ECT). We investigated sociodemographic and clinical characteristics, service use, and psychotropic medication prescription patterns associated with ECT use at a Veterans Health Administration Medical Center.

Methods: Among veterans receiving specialty mental health services, we compared those who received ECT with those who did not using bivariate χ and t tests and multivariate logistic regression.

Results: In fiscal year 2012, 11,117 veterans received specialty mental health services, of whom 50 received ECT (0.45%) in FY2012 or FY2013. Those who received ECT were more likely to be diagnosed with major depressive or bipolar disorders and had substantially higher levels of mental health service usage (Cohen d > 0.75) and psychotropic prescription fills, including antidepressants (Cohen d = 2.66), antipsychotics (Cohen d = 2.15), lithium (Cohen d = 1.34), mood stabilizers (Cohen d = 1.30), and anxiolytic/sedative/hypnotics (Cohen d = 1.34).

Conclusions: Our findings suggest that ECT is used as a treatment of last resort, although available evidence and guidelines recommend wider use.

MeSH terms

  • Adult
  • Aged
  • Bipolar Disorder / epidemiology
  • Bipolar Disorder / therapy
  • Depressive Disorder, Major / epidemiology
  • Depressive Disorder, Major / therapy
  • Drug Utilization
  • Electroconvulsive Therapy / statistics & numerical data*
  • Female
  • Hospitals, Veterans / statistics & numerical data*
  • Humans
  • Male
  • Mental Health Services
  • Middle Aged
  • Psychotropic Drugs / therapeutic use
  • United States / epidemiology
  • United States Department of Veterans Affairs
  • Veterans

Substances

  • Psychotropic Drugs