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The effectiveness of involuntary electroconvulsive therapy (ECT): A population-based study

Published online by Cambridge University Press:  13 August 2021

E. Salagre ,
C. Rohde ,
K. Ishtiak-Ahmed ,
C. Gasse  and
S. Østergaard
E. Salagre*
Affiliation:
Bipolar And Depressive Disorders Unit, Hospital Clinic - IDIBAPS - Universitat de Barcelona - CIBERSAM, Barcelona, Spain
C. Rohde
Affiliation:
Department Of Affective Disorders, Aarhus University Hospital, Aarhus, Denmark
K. Ishtiak-Ahmed
Affiliation:
Department Of Affective Disorders, Aarhus University Hospital, Aarhus, Denmark
C. Gasse
Affiliation:
Department Of Affective Disorders, Aarhus University Hospital, Aarhus, Denmark
S. Østergaard
Affiliation:
Department Of Clinical Medicine, Aarhus University, Aarhus, Denmark
*
*Corresponding author.

Abstract

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Introduction

Involuntary electroconvulsive therapy (ECT) can be a life-saving intervention for patients suffering from potentially lethal conditions who are unable to give informed consent. However, its use is not widespread, probably partly due to the scarce data on hard outcomes following involuntary ECT. In Denmark, involuntary ECT is only used when patients are at imminent/potential risk of dying if not receiving ECT.

Objectives

We aimed to assess the effectiveness of involuntary ECT by estimating the 1-year survival following its administration.

Methods

We conducted a register-based cohort study involving i) all patients receiving involuntary ECT in Denmark between 2008 and 2019, ii) age and sex-matched patients receiving voluntary ECT, and iii) age and sex-matched individuals from the general population. 1-year survival rates were compared via mortality rate ratios.

Results

We identified 618 patients receiving involuntary ECT, 547 patients receiving voluntary ECT, and 3,080 population-based controls. The survival rate in the year after involuntary ECT was 90%. For patients receiving involuntary ECT, the 1-year mortality rate ratios were 3.1 (95% confidence interval (CI)= 1.9-5.2) and 5.8 (95%CI = 4.0-8.2) compared to those receiving voluntarily ECT and to the population-based controls, respectively. Risk factors for early death among patients receiving involuntary ECT were male sex, being ≥70 years old and having organic mental disorder as the treatment indication.

Conclusions

Treatment with involuntary ECT is associated with a high survival rate, suggesting that the intervention is effective. However, patients receiving involuntary ECT constitute a high-risk population that should be monitored closely after this treatment.

Disclosure

No significant relationships.

Keywords

Electroconvulsive therapyInformed ConsentSurvival rateRisk factorsPopulation Register
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S151 - S152
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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