Electroconvulsive practice in Singapore: a cross-sectional national survey.


Journal

Singapore medical journal
ISSN: 2737-5935
Titre abrégé: Singapore Med J
Pays: India
ID NLM: 0404516

Informations de publication

Date de publication:
Nov 2019
Historique:
pubmed: 15 6 2019
medline: 29 7 2020
entrez: 15 6 2019
Statut: ppublish

Résumé

The use of electroconvulsive therapy (ECT) in Singapore dates back to 1947. However, there is little local information on the clinical practice of ECT and its standards. We aimed to conduct a comprehensive national survey of ECT practice in Singapore. A cross-sectional structured questionnaire assessing the types of ECT (e.g. electrode placement, stimulus parameters), indications, anaesthetic technique, dosing methods, monitoring of outcomes and credentialing was sent in 2015 to all ECT centres in Singapore via email to collect qualitative and quantitative data regarding ECT. Data was obtained from all ECT centres (n = 6), which represented that ECT was available in 23.1% of all hospitals and 50.0% of all psychiatric specialist centres. The rate of ECT was 5.89 treatments per 10,000 residents per year, and each patient received an average of 5.4 ECT per course. Only 7.0% of ECT was administered for continuation/maintenance ECT. The most common indication for ECT was depression in 5 (83.3%) out of six centres, with schizophrenia being the second most common. In 5 (83.3%) out of six centres, ECT was brief (0.5 ms) bitemporal ECT with age-based dosing, and 93.0% of the sessions were conducted in an inpatient setting. All ECT was conducted under general anaesthesia, with propofol (66.7%) being the most common type of anaesthetic used. The practice of ECT in Singapore was highly uniform. The rates and indications for ECT were consistent with those of other developed countries, with greater use of ECT for schizophrenia. Future advances for ECT in Singapore include the use of individualised dosing based on empirical seizure threshold titration, expanded electrode placements and increased utilisation of continuation/maintenance ECT.

Identifiants

pubmed: 31197378
pii: j60/11/590
doi: 10.11622/smedj.2019064
pmc: PMC6875809
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

590-595

Informations de copyright

Copyright: © Singapore Medical Association.

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Auteurs

Phern-Chern Tor (PC)

Department of General Psychiatry, Institute of Mental Health, Singapore.

Verònica Gálvez (V)

School of Psychiatry, University of New South Wales, Sydney, Australia.
Black Dog Institute, Sydney, Australia.

Aaron Ang (A)

Department of Psychological Medicine, Tan Tock Seng Hospital, Singapore.

Johnson Fam (J)

Department of Psychological Medicine, National University Hospital, Singapore.

Herng-Nieng Chan (HN)

Department of Psychological Medicine, Singapore General Hospital, Singapore.

Sheng-Neng Tan (SN)

Department of Psychological Medicine, Changi General Hospital, Singapore.

Colleen K Loo (CK)

School of Psychiatry, University of New South Wales, Sydney, Australia.
Black Dog Institute, Sydney, Australia.
Department of Psychiatry, St George Hospital, Sydney, Australia.

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