Changes in the Practice of Electroconvulsive Therapy in Poland: A Nationwide Survey Comparing Data Between 2005 and 2020.
ECT in Poland
ECT in central and eastern Europe
ECT utilization rate
electroconvulsive therapy
survey
Journal
Neuropsychiatric disease and treatment
ISSN: 1176-6328
Titre abrégé: Neuropsychiatr Dis Treat
Pays: New Zealand
ID NLM: 101240304
Informations de publication
Date de publication:
2021
2021
Historique:
received:
07
12
2020
accepted:
14
01
2021
entrez:
3
3
2021
pubmed:
4
3
2021
medline:
4
3
2021
Statut:
epublish
Résumé
The use and the characteristics of the practice of electroconvulsive therapy (ECT) in Poland have not been evaluated since 2005, when a nationwide survey revealed its rare utilization (0.11 patients/10,000 inhabitants/year). The aims of this study were to determine the current use of ECT and to compare the findings with those of the previous survey. Two questionnaires were sent to all 48 inpatient psychiatric centers in Poland. The first one - to units providing ECT to explore its practice, and the second - to units not performing ECT to explore the reasons for not using this treatment. Nineteen (39.6%) of all psychiatric inpatient centers confirmed the use of ECT. The utilization rate was 0.13 patients/10,000 inhabitants. Similar to the findings from 2005, the main indications were affective disorders, and bitemporal electrode placement was the dominant method used for the delivery of ECT. Age-based and titration-based methods were applied exclusively in 50% and 25% of the centers, respectively (compared with 15% and 35% in 2005, respectively), while both methods were used in the remaining 25%. Improvements in safety were reflected by the use of comprehensive pre-ECT evaluation and treatment monitoring. None of the centers used sine-wave devices; this contrasts with their use by 29% of the centers in 2005. The main reasons for not using ECT were insufficient funding and a lack of experienced staff. The frequency of ECT use in Poland remains very low. In view of the improvement in the quality of health services in the past decade, such a markedly rare use of an effective treatment was unexpected. There is an urgent need of education to create more positive attitude towards ECT among health professionals and among public, and to increase the training of mental health professionals in ECT.
Sections du résumé
BACKGROUND
BACKGROUND
The use and the characteristics of the practice of electroconvulsive therapy (ECT) in Poland have not been evaluated since 2005, when a nationwide survey revealed its rare utilization (0.11 patients/10,000 inhabitants/year). The aims of this study were to determine the current use of ECT and to compare the findings with those of the previous survey.
METHODS
METHODS
Two questionnaires were sent to all 48 inpatient psychiatric centers in Poland. The first one - to units providing ECT to explore its practice, and the second - to units not performing ECT to explore the reasons for not using this treatment.
RESULTS
RESULTS
Nineteen (39.6%) of all psychiatric inpatient centers confirmed the use of ECT. The utilization rate was 0.13 patients/10,000 inhabitants. Similar to the findings from 2005, the main indications were affective disorders, and bitemporal electrode placement was the dominant method used for the delivery of ECT. Age-based and titration-based methods were applied exclusively in 50% and 25% of the centers, respectively (compared with 15% and 35% in 2005, respectively), while both methods were used in the remaining 25%. Improvements in safety were reflected by the use of comprehensive pre-ECT evaluation and treatment monitoring. None of the centers used sine-wave devices; this contrasts with their use by 29% of the centers in 2005. The main reasons for not using ECT were insufficient funding and a lack of experienced staff.
CONCLUSION
CONCLUSIONS
The frequency of ECT use in Poland remains very low. In view of the improvement in the quality of health services in the past decade, such a markedly rare use of an effective treatment was unexpected. There is an urgent need of education to create more positive attitude towards ECT among health professionals and among public, and to increase the training of mental health professionals in ECT.
Identifiants
pubmed: 33654402
doi: 10.2147/NDT.S296210
pii: 296210
pmc: PMC7910084
doi:
Types de publication
Journal Article
Langues
eng
Pagination
605-612Informations de copyright
© 2021 Antosik-Wójcińska et al.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest in this work.
Références
J ECT. 2016 Mar;32(1):29-32
pubmed: 26252554
Psychiatr Pol. 2008 Nov-Dec;42(6):825-39
pubmed: 19441662
Psychiatr Pol. 2008 Nov-Dec;42(6):797-818
pubmed: 19441660
Psychiatr Pol. 2002;36(2):259-69
pubmed: 12043043
Aust N Z J Psychiatry. 2019 Jul;53(7):609-623
pubmed: 30966782
Psychiatr Danub. 2017 Jun;29(2):136-140
pubmed: 28636570
Psychiatr Danub. 2014 Mar;26(1):66-9
pubmed: 24608157
J ECT. 2009 Jun;25(2):85-90
pubmed: 19092676
Brain Stimul. 2008 Apr;1(2):71-83
pubmed: 19756236
J ECT. 2018 Jun;34(2):108-112
pubmed: 29166317
Curr Opin Anaesthesiol. 2018 Oct;31(5):501-505
pubmed: 29994943
J ECT. 2016 Mar;32(1):70
pubmed: 26075695
J ECT. 2007 Jun;23(2):82-8
pubmed: 17548976
J ECT. 2017 Dec;33(4):260-263
pubmed: 28640171
J ECT. 2004 Mar;20(1):42-4
pubmed: 15087996
World J Biol Psychiatry. 2013 Aug;14(6):432-40
pubmed: 22409536
J ECT. 2016 Mar;32(1):55-61
pubmed: 26332499
Lancet. 2003 Mar 8;361(9360):799-808
pubmed: 12642045
World J Biol Psychiatry. 2014 Jul;15(5):419-24
pubmed: 24329398
Brain Behav. 2012 May;2(3):283-344
pubmed: 22741102
J ECT. 2012 Jun;28(2):108-10
pubmed: 22531203
J ECT. 2014 Sep;30(3):216-9
pubmed: 24487647
J ECT. 2016 Dec;32(4):236-242
pubmed: 27227401
Psychol Med. 2017 Feb;47(3):518-530
pubmed: 27780482
J ECT. 2005 Sep;21(3):151-7
pubmed: 16127303
Psychiatr Danub. 2021 Fall;33(3):328-333
pubmed: 34795174