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. 2022 Mar 1;38(1):45-51.
doi: 10.1097/YCT.0000000000000800.

The Impact of COVID-19 on Electroconvulsive Therapy: A Multisite, Retrospective Study From the Clinical Alliance and Research in Electroconvulsive Therapy and Related Treatments Network

Elaine Kwan  1 , Brandon Le  1 , Colleen K Loo, Vanessa Dong, Phern-Chern Tor  2 , Don Davidson  3 , Titus Mohan  3 , Susan Waite  4 , Grace Branjerdporn  5 , Shanthi Sarma  5 , Salam Hussain, Donel M Martin
Affiliations

The Impact of COVID-19 on Electroconvulsive Therapy: A Multisite, Retrospective Study From the Clinical Alliance and Research in Electroconvulsive Therapy and Related Treatments Network

Elaine Kwan et al. J ECT. .

Abstract

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has led to reported change in electroconvulsive therapy (ECT) services worldwide. However, minimal data have been published demonstrating tangible changes across multiple ECT centers. This article aimed to examine changes in ECT patients and ECT service delivery during the pandemic.

Methods: We retrospectively assessed data collected on ECT patients within the Clinical Alliance and Research in Electroconvulsive Therapy and Related Treatments (CARE) Network during a 3-month period starting at the first COVID-19 restrictions in 2020 and compared data with predicted values based on the corresponding 3-month period in 2019. Mixed-effects repeated-measures analyses examined differences in the predicted and actual number of acute ECT courses started and the total number of acute ECT treatments given in 2020. Sociodemographic, clinical, treatment factors, and ECT service delivery factors were compared for 2020 and 2019.

Results: Four Australian and 1 Singaporean site participated in the study. There were no significant differences between the predicted and actual number of acute ECT courses and total number of acute ECT treatments administered in 2020. During 2020, there were statistically significant increases in the proportion of patients requiring ECT under substitute consent and receiving ECT for urgent reasons compared with 2019.

Conclusions: This multisite empirical study is among the first that supports anecdotal reports of changes in the triaging and delivery of ECT during COVID-19. Results suggest that ECT was prioritized for the most severely ill patients. Further data assessing the impacts of COVID-19 on ECT are needed.

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Conflict of interest statement

E.K. declares honoraria from the Lundbeck Institute outside the submitted work. C.K.L. reports equipment support from Mecta for research. D.M.M. and V.D. were supported by a National Health and Medical Research grant awarded to C.L. (Grant No. 1195651). The other authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Number of acute ECT courses started during the 3-month study period.
FIGURE 2
FIGURE 2
Total number of acute ECT sessions during the 3-month study period.
See this image and copyright information in PMC

References

    1. American Psychiatric Association . COVID-19 pandemic guidance document: electroconvulsive therapy as an essential procedure. Available at: https://www.psychiatry.org/File%20Library/Psychiatrists/APA-Guidance-ECT.... Accessed October 25, 2020.
    1. Royal Australian and New Zealand College of Psychiatrists . Information about the provision of ECT treatment during the COVID-19 pandemic. 2020. Available at: https://www.ranzcp.org/files/resources/college_statements/practice_guide.... Published April 2020. Accessed June 27, 2020.
    1. Royal College of Psychiatrists . Continuing to provide ECT during the COVID-19 pandemic. 2020. Available at: https://www.rcpsych.ac.uk/docs/default-source/about-us/covid-19/ect-covi.... Accessed July 11, 2020.
    1. Department of Psychiatry National Institute of Mental Health & Neurosciences . Mental Health in the Times of COVID-19 Pandemic: Guidance for General Medical and Specialised Mental Health Care Settings. Bengaluru, India: National Institute of Mental Health & Neurosciences; 2020.
    1. International Society for ECT and Neurostimulation . Position statement on ECT as an essential procedure during COVID-19. Available at: https://www.isen-ect.org/covid-19-essential-procedure. 2020. Accessed January 5, 2021.

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