Electroconvulsive therapy in Norway: rates of use, clinical characteristics, diagnoses, and attitude.

OBJECTIVES: The aim of the study was to describe the rate of use and demographic distribution of electroconvulsive therapy (ECT) in Norway in 2004, as well as the attitudes among Norwegian psychiatrists about ECT. METHODS: A 42-item questionnaire on the practice of ECT was sent to 125 Norwegian psychiatric hospitals, district psychiatric centers, and child and adolescent psychiatric units in 2004. RESULTS: A total of 67 (54%) psychiatric units responded, including 26 (67%) of 39 psychiatric hospitals, 32 (46%) of 69 district psychiatric centers, and 9 (53%) of 17 child and adolescent units. There were 672 patients who received ECT during 2004, which gives a yearly incidence of 2.4 of 10,000 inhabitants. A total of 5.3% of all inpatients received ECT.The rate of ECT use varied from 1.83 to 3.44 per 10,000 inhabitants per year between the different health regions.Of the 672 patients, 394 reported their sex (59%), of which 135 were men and 259 were women (male-female ratio, 1:2). The most common diagnosis treated with ECT was depression, followed by bipolar disorder and schizoaffective disorder.The responders expressed generally positive attitudes toward ECT. Almost all considered ECT important, that hospitals should offer ECT, and that there are solid indications for such treatment. Most of the responders expressed concern about the underuse of ECT. CONCLUSIONS: Electroconvulsive therapy is widely available in Norway but its use is unevenly distributed between health regions. The attitudes toward ECT are generally positive among psychiatrists.

Questionnaire study about the practice of electroconvulsive therapy in Norway.

OBJECTIVES: The aim of the study was to describe the contemporary practice of electroconvulsive therapy (ECT) in Norway. METHODS: A 42- item questionnaire on the practice of ECT was sent to all the 125 Norwegian psychiatric hospitals, district psychiatric centers, and child and adolescent psychiatric units in 2004. RESULTS: A total of 67 (54%) psychiatric units responded, including 26 (67%) of 39 psychiatric hospitals, 32 (46%) of 69 district psychiatric centers, and 9 (53%) of 17 child and adolescents units. Trainee psychiatrists mostly administered ECT, with or without supervision, but underwent a training program before administering ECT. Written informed consent was used in 50% of institutions providing ECT. Right unilateral electrode placement was preferred but with variations in dosage strategies. The practice in most of the departments was to discontinue some classes of psychotropics before ECT, mostly benzodiazepines and anticonvulsants. Antidepressants and antipsychotics were most often continued. Continuation/maintenance and ambulatory ECT were used. Most patients benefited from ECT. Headache and memory impairment were frequent but seldom were serious adverse effects. CONCLUSIONS: The administration of ECT in Norway in 2004 was mostly in accordance with international guidelines. All institutions used modified ECT and brief pulse machines, and unilateral ECT was the preferred electrode placement. National guidelines should be developed, as there were great variations in practice among the hospitals.