Electroconvulsive therapy in Denmark

In yesterday’s post I mentioned a Danish article about the use of electroconvulsive therapy (ECT) in forensic patients. Today the website  of the Danish broadcaster DR has a brief news item entitled “Huge increase in electroshock therapy“.

“The number of mental illnesses being treated with electroconvulsive (electroshock) therapy has increased hugely in recent years. In 2003 the therapy was administered in around 15,000 cases, while in 2010 the figure had risen to more than 20,000. For some patients, however, the treatment can result in long-term memory loss.”

That is 20,000 individual administrations of ECT, or about 2,000 courses at a rate of about 10 treatments per course, according to another DR article. The population of Denmark is about five and a half million, so 2,000 courses a year is a very high use – similar to, for example, Victoria, Australia.

The article continued with a quote from a patient who had had ECT and been left with memory loss: ““I’ve lost some of 2007 and some of 2008. And 2009 is completely gone,” Susanne Jørgensen told DR“.

The figure of 20,000 treatments is very close to the figure of nearly 40 years ago, although the number of courses is lower today (with more treatments per course). In 1972-1973 22,210 treatments in 3,438 courses were given.  48 psychiatric departments reported ECT use; of these 21 used exclusively bilateral ECT, 12 used exclusively unilateral, and 15 used both. (J. Heshe and E. Roeder 1976 Electroconvulsive therapy in Denmark. British Journal of Psychiatry, 128, 241-5). This was a comparatively high use of unilateral ECT use, and it would be interesting to know how it compares to today’s practice in Denmark.

A survey in 1999 found:

“…that the number of ECT sessions had fallen from 19,564 in 1979 to 16,306 in 1999 and the number of ECT patients from 2,332 in 1979 to 1,710 in 1999. ECT is thus given to an average of 5% of all hospitalised psychiatric patients. The number of sessions per patient had increased slightly”.

So it would appear that the number of courses of ECT approximately halved between 1972 and 1999, but has increased slightly in recent years. And today people have longer courses, hence the “huge” increase.

Also coming out of Denmark recently is an interesting article by Jesper V. Kragh in the July 2010 issue of Medical History. The article, entitled “Shock therapy in Denmark” looks at the introduction of convulsive therapy (specifically cardiazol therapy, in which seizures were induced with a drug and which was a forerunner of ECT) into Denmark and how, even after a survey had shown it was of little use as a treatment for schizophrenia and had serious damaging effects, psychiatrists continued to promote it in the press, finding it useful in their attempts to align psychiatry to the rest of medicine, as well as to control the behaviour of patients and as a treatment for various other disorders. Denmark incidentally had the highest rate of leucotomies of any country for which statistics are available, and Jesper V. Kragh has also written on this subject.

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