Comparison of electroconvulsive therapy practice between London and Bengaluru

TY - JOUR

T1 - Comparison of electroconvulsive therapy practice between London and Bengaluru

AU - Eranti, Savithasri V

AU - Thirthalli, Jagadisha

AU - Pattan, Vivek

AU - Mogg, Andrew

AU - Pluck, Graham

AU - Velayudhan, Latha

AU - Chan, Jenifer

AU - Gangadhar, Bangalore N

AU - McLoughlin, Declan M

PY - 2011/12

Y1 - 2011/12

N2 - OBJECTIVE: To compare electroconvulsive therapy (ECT) practice between London in the United Kingdom and Bengaluru in India.METHODS: A retrospective case note study was conducted to compare patterns of referrals for ECT in university teaching hospitals in London (n = 46) and Bengaluru (n = 345) during a 1-year period. Further comparison of ECT practice was made for a consecutive series of depressed patients between London (n = 104) and Bengaluru (n = 125).RESULTS: The rates of ECT referral were 0.9% of total annual admissions at the London site and 8.2% at the Bengaluru site. At the Bengaluru site, a higher proportion of patients were referred for ECT with a diagnosis of schizophrenia (P < 0.0001). Compared to the Bengaluru sample, depressed patients treated with ECT in London (n = 104) were older with more treatment resistance (P < 0.0001), had longer inpatient stays, and were less responsive to ECT.CONCLUSIONS: The practice of ECT differed substantially between the London and Bengaluru sites. The relatively limited use of ECT in London reflects local treatment guidelines and may reflect the stigma associated with ECT. Electroconvulsive therapy is more widely used in Bengaluru with good outcomes. Further cross-cultural research is required to study the reasons for such contrasting practices and what constitutes the optimal practice of ECT for health systems in different countries.

AB - OBJECTIVE: To compare electroconvulsive therapy (ECT) practice between London in the United Kingdom and Bengaluru in India.METHODS: A retrospective case note study was conducted to compare patterns of referrals for ECT in university teaching hospitals in London (n = 46) and Bengaluru (n = 345) during a 1-year period. Further comparison of ECT practice was made for a consecutive series of depressed patients between London (n = 104) and Bengaluru (n = 125).RESULTS: The rates of ECT referral were 0.9% of total annual admissions at the London site and 8.2% at the Bengaluru site. At the Bengaluru site, a higher proportion of patients were referred for ECT with a diagnosis of schizophrenia (P < 0.0001). Compared to the Bengaluru sample, depressed patients treated with ECT in London (n = 104) were older with more treatment resistance (P < 0.0001), had longer inpatient stays, and were less responsive to ECT.CONCLUSIONS: The practice of ECT differed substantially between the London and Bengaluru sites. The relatively limited use of ECT in London reflects local treatment guidelines and may reflect the stigma associated with ECT. Electroconvulsive therapy is more widely used in Bengaluru with good outcomes. Further cross-cultural research is required to study the reasons for such contrasting practices and what constitutes the optimal practice of ECT for health systems in different countries.

KW - Adult

KW - Depression

KW - Electroconvulsive Therapy

KW - England

KW - Female

KW - Humans

KW - India

KW - Male

KW - Middle Aged

KW - Retrospective Studies

KW - Comparative Study

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1097/YCT.0b013e31820f8f7c

DO - 10.1097/YCT.0b013e31820f8f7c

M3 - Article

C2 - 21673590

VL - 27

SP - 275

EP - 280

JO - JOURNAL OF ECT

JF - JOURNAL OF ECT

IS - 4

ER -