ECT in Greece and Turkey

Greece and Turkey are neighbouring countries, but they have very different rates of use of electroconvulsive therapy (ECT).

Recently the Journal of ECT published the results of a survey of electroconvulsive therapy (ECT) use in Greece (SC Kaliora et al 2013 The practice of electroconvulsive therapy in Greece. E-pub ahead of print). The survey found that in 2007 a total of 137 people were treated with ECT. Greece has a population of about 11.3 million, so that represents a very low use of ECT (about one twentieth its rate of use in Victoria, Australia, for example, or less than one fifth its rate of use in Scotland). Schizophrenia was the most common diagnosis of those undergoing ECT. Treatment was always given with anaesthesia; the electrode placement was always bilateral; seven out of the 18 hospitals which used ECT did not try to estimate the patient’s seizure threshold.

In Turkey, meanwhile, just one hospital (Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases in Istanbul) accounted for 3,490 ECT patients over a three year period, 2008-2010, according to an article by O. Canbek and colleagues in the January issue of the Journal of ECT. Men outnumbered women by over 3 to 2. An earlier study from the same hospital by O. Saatcioglu and NB Tomruk, covering the period 2006-2007, revealed that the majority of ECT patients were being treated for mania or schizophrenia. Eighty-one per cent of patients were under the age of 45.

In 2005, Turkey came in for criticism over the use of unmodified ECT, for example in this article in the New York Times. But it would appear from this survey that by 2006, at least in the Bakirkoy Hospital, patients were being given modified ECT.

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