ECT in Scotland

More is known about the use of ECT in recent years in Scotland than in other parts of the United Kingdom, due largely to the fact that some of the big names of ECT in UK are based in Edinburgh and the setting up the government-funded Scottish ECT Accreditation Network (SEAN).

In common with other parts of the UK, the number of people undergoing ECT in Scotland has declined in recent years. In 1979 there were about 2,880 courses of ECT and Scottish use was just about average for the UK. By 2008 the number of courses had dropped to about 507, a fall of over 80 per cent. However, unlike in the rest of the UK where ECT use was falling throughout the 1980s and 1990s, most of this fall has occurred in the past 15 years. An estimated 2,598 patients received ECT in 1995, when the Clinical Resource and Audit Group (CRAG) of the Scottish Executive health department conducted their first survey of ECT practice in Scotland.

The 2009 annual report of SEAN provides information about the use of ECT in Scotland in 2008.

  • About 507 courses of ECT were given to about 420 patients during 2008. Most of the patients were being treated for depression (information was available about 436 of these courses and 362 of these patients).
  • 72 per cent of the patients were women (the authors say that this “reflects the relative percentages of patients being treated for depressive illness”, but the figures they cite show a 62/38 split)
  • Nearly 40 per cent of patients had already received ECT in the previous 3 years. A small number were receiving maintenance ECT.
  • ECT was usually given twice a week. 91 per cent of courses involved bilateral electrode placement.
  • 23 per cent of patients were deemed to lack capacity and were treated without their consent
  • The mean age of patients was 59.  The oldest was 95, the youngest 22. No-one under the age of 20 had been given ECT since 2005

The use of ECT in Edinburgh has been subjected to even closer scrutiny. A paper published in 1999 found that ECT use at the Royal Edinburgh Hospital fell by over 50 per cent between 1992 and 1997, and that people aged over 65 were three times as likely to be given ECT than people aged 18-64. Another paper published in 2000 identified an 18-fold difference in the amount of ECT used by the 14 consultant-led teams at the Royal Edinburgh Hospital.

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