Electroconvulsive therapy in Hong Kong: Rates of use, indications, and outcome

Abstract

Introduction: There has been a concern about indiscriminate use of electroconvulsive therapy (ECT) in Asian countries. This study examined the rates of ECT use and the characteristics and outcomes of patients treated with ECT in Hong Kong. Method: A central database of ECT treatments was used to calculate annual rates of ECT use from 1997 to 2002. We surveyed prospectively patients received ECT over 12 months by a standardized questionnaire. Results: The ECT utilization rates varied from 0.27 to 0.34 patients treated per 10,000 population and 1.34 to 1.88 patients treated per 100 inpatients discharged. There were differences in the pattern of ECT use among Hong Kong, the United States, and the United Kingdom. Only 15% of ECT recipients were 65 years old or older and 23% had schizophrenia as primary diagnosis for ECT. Ninety-five percent of patients who received ECT improved with the treatment as assessed by clinicians. No severe complications and deaths occurred, and 6% stopped ECT due to undesirable results. Conclusion: The rate of ECT use in Hong Kong continues to be below that in the United States and the United Kingdom. Access to ECT is most limited to the elderly and private patients.