Socioeconomic status of patients receiving electroconvulsive therapy

Abstract

This study describes the relationship between socioeconomic deprivation and electroconvulsive therapy (ECT) prescription and outcomes. Two research questions are addressed in this study: (1) Does the rate of ECT prescription increase with deprivation? and (2) Does deprivation influence ECT outcomes? Electroconvulsive therapy outcomes, of consecutive patients from Aberdeen, were compared across socioeconomic groups determined by the Scottish Index of Multiple Deprivation (SIMD) quintiles. A primary care sample, invited to complete the Hospital Anxiety and Depression Scale (HADS), was used for comparison. The proportion of patients in the most affluent quintile (32%) was greater than that in the least affluent (9%): this reflects the distribution of the local population, unlike the prevalence of depressive disorder, as demonstrated in our primary care group. Severity of depressive symptoms in patients receiving ECT was no different across the socioeconomic groups: before ECT (χ = 8.056; df = 4; P = 0.09), after ECT (χ = 6.035; df = 4; P = 0.197); nor was the total change in score (χ = 4.367; df = 4; P = 0.359). There were no differences among the SIMD quintiles for the number of ECT treatments administered (χ = 6.076; df = 4; P = 0.194) or the number of courses of ECT each patient had during contact with the service (χ = 6.505; df = 4; P = 0.164).Socioeconomic deprivation has no effect on the rate of ECT prescription or treatment outcomes despite a higher proportion of patients with severe depressive symptoms in the least affluent groups in a local community sample.