Aims and methodThe use of electroconvulsive therapy (ECT) was surveyed over the first six months of 1996 in Wales. Data on the indications for ECT and clinical outcome were collected in the first three months.ResultsThe computed annual rate was 22 patients treated with ECT per 100 000 population. Women constituted 71% of those receiving ECT (236/321). Eighty-three per cent had an affective disorder, and 80% had failed to respond to previous treatments. Only 33% of patients had been prescribed more than one class of antidepressant and only 25% had received augmentation with lithium or an alternative drug before being given ECT.Clinical implicationsECT is mostly used after a failure of patients to respond adequately to a course of antidepressants.