Improving Practice in Electroconvulsive Therapy: A Nationwide Survey in Belgium

Abstract

Objective: The aims of this study were to review the practice of electroconvulsive therapy (ECT) in Belgium and to compare it with the practice of ECT a decade ago.

Methods: A 30-item questionnaire on the practice of ECT was sent to all institutions providing ECT. Results were compared with the results of a survey performed in 2003.

Results: In 2013 to 2014, ECT was performed in 13.7% of all psychiatric services, equaling 1 ECT unit per 584,187 inhabitants. Fifteen of the 19 psychiatric services (78.94%) providing ECT replied to the questionnaire. Practice of ECT has improved significantly.

Limitations: This questionnaire study relies upon answers given by psychiatrists and did not audit actual practices.

Conclusions: The past decade, Belgium has witnessed significant changes in the practice of ECT. The number of facilities providing ECT almost halved adding to the growing expertise of fewer but larger ECT facilities. A possible down side to specialization is a potential diminution of the availability of ECT, requiring adequate referral policies in hospitals without ECT facilities. Although the practice significantly improved, continuous education is needed.