Use of electroconvulsive therapy in the Baltic states

Abstract

Objectives: While the use of electroconvulsive therapy (ECT) has been investigated worldwide, nothing is known about its use in the Baltic states. The purpose of this study was thus to explore ECT practice in the three Baltic countries.

Methods: A 21-item, semi-structured questionnaire was sent out to all psychiatric inpatient settings that provided ECT in 2010.

Results: In Lithuania, four services provided ECT in 2010. Only modified ECT with anaesthesia and muscle relaxation is performed in the country. In 2010, approximately 120 patients received ECT, i.e., 0.375 patients/10,000 population. Only two centres offer ECT in Latvia. The first centre treated only three patients with ECT in 2010, while the second centre six patients. In both centres outdated Soviet machines are used. The main indication for ECT was severe, malignant catatonia. ECT is practiced in five psychiatric facilities in Estonia. In 2010, it was used in the treatment of 362 patients (17% women) nationwide, i.e., 2.78 patients/10,000 population. Only a senior psychiatrist may indicate ECT in Estonia and pregnancy is no contraindication. In 2010, the main indication for ECT was schizophrenia (47.8%).

Conclusions: This 2010 survey revealed significant differences in the use and availability of ECT between the Baltic countries.

Keywords: Baltic states; affective disorders; electroconvulsive therapy practice; schizophrenia; suicide.