Every year Scottish psychiatrists produce a report on the use of ECT in Scotland. This year’s report, published earlier this month, reports on the use of ECT in Scotland during 2014. There has been very little change in the amount of ECT used since the previous year: the number of patients and courses were down slightly, but the total number of treatments up slightly. During 2014, 357 people received 434 courses of treatment, or 4,443 individual treatments.
As in previous years, women accounted for more than two-thirds of ECT patients. Just over one in three ECT patients did not consent to treatment but were deemed to lack capacity and given the treatment without their consent and sometimes in spite of the fact that they were refusing or resisting the treatment.
ECT patients in Scotland are getting older. In 2014 the mean age of consenting ECT patients was 58 years and of non-consenting patients 67, up from 57 and 64 respectively in 2013. About 24 per cent of ECT patients in 2014 were aged under 50, about 45 per cent aged between 50 and 70, and about 31 per cent aged over 70. If you are a woman over 80 in Scotland, you are more likely to get ECT than if you are a woman under 40. It is interesting to compare these figures to those from Texas, one of the few other places to produce annual statistics on ECT use. The rate of ECT use in Scotland and Texas is much the same; and guidelines, etc., produced by British and American psychiatrists would appear to show in theory a broad agreement about its use. But in practice ECT is being given to different groups of people: Scottish patients are older, and their age is increasing, and they are much less likely to consent to treatment than patients in Texas.
In Scotland unilateral ECT is seldom used: just one in 25 patients received a course of treatment consisting entirely of unilateral treatment.