Diagnosis and evaluation of ECT

Abstract

This study has shown that the administration of ECT is not random with respect to diagnosis, month of the year (season) or previous ECT. Using total number of treatments and courses of treatments and specific rates it was found that the affective disorders constituted the largest treatment group. This is in keeping with the standard textbooks, Ottosson's concept that electric seizures have a specific effect upon depression and d'Elia's recommendation that ECT is the treatment of choice for endogenous depression. The role of ECT in nonaffective disorders still requires clarification since, while its prescription here may be clinically expedient and even efficient, the efficacy and specificity are not well documented. In this study the affective disorders and schizoaffective disorders constituted 51% of the ECT subgroup, but neurotic disorders and schizophrenia made up a further 46%. While the reasons for prescribing ECT in these cases were not usually documented, it is known that 41% of the neurotic depressives had made a suicidal attempt or were regarded as as serious suicidal risk. The tendency towards specific and, therefore, non random prescription of ECT for affective disorders is indicative of sound clinical practice. Since safe and specific measures are the aim of clinical medicine, then it has an assured place in Canadian practice and should not be undervalued or legally restrained.