Electroconvulsive Therapy Practice in the Kingdom of Denmark

Abstract

Objectives The aim of this study was to survey and describe the contemporary practice of electroconvulsive therapy (ECT) in the Kingdom of Denmark (Denmark, Greenland, and the Faroe Islands). Methods Data regarding number of ECTs and number of patients with different diagnoses treated with ECT were retrieved from the Danish National Patient Registry. In addition, a 45-item questionnaire was sent to all psychiatric departments practicing ECT in Denmark (n = 26), Greenland (n = 1), and the Faroe Islands (n = 1). Results According to the Danish National Patient Registry, a total of 21,730 ECTs were administered to 1891 unique patients in 2017. All departments responded to the survey. The psychiatric departments' attitude toward ECT was generally favorable and in accord with official guidelines. Maintenance ECT was used in all departments but one. Bilateral electrode placement was preferred. All departments used a preselected age-based dosing strategy. Involuntary ECT was performed in 96% of the psychiatric departments, but infrequently (3% of all treatments). All departments used a Thymatron (brief pulse) device, and in 71% of the departments, ECT was given in a specialized ECT unit and preanesthetic evaluation was carried out in all departments. The departments reported several different practices regarding documentation and monitoring of treatment effect, patient consent, screening for side effects (including cognitive side effects), and guidelines for the discharge of ECT patients. Conclusions Electroconvulsive therapy is frequently used in Denmark, Greenland, and the Faroe Islands in a relatively uniform way in adherence with clinical guidelines.

Electroconvulsive therapy following incident bipolar disorder: When, how, and for whom?

“…Regarding the administration of ECT in incident BD, our results are similar to the findings of previous register‐based studies examining the use of ECT across a wider range of mental disorders. 9 The most common electrode placement was bilateral, and most patients received their first ECT during an admission, likely reflecting the severity of the condition leading to the referral to ECT. Hence, once the decision of prescribing ECT has been made by mutual consent with the patient (whenever feasible), clinicians seem to prioritize efficacy over tolerability, that is, bilateral over unilateral electrode placement.…”

“…We performed a population‐based cohort study using nationwide data from Danish registries. 8 Compared to other European and non‐European countries, Denmark has a relatively high ECT utilization, 9 , 10 and the administration of ECT is quite standardized across psychiatric services in accordance with the national clinical guidelines for ECT published by the Danish Psychiatric Society. 11…”

“…However, data on ECT treatments in the DNPR are assumed to be stable and credible only from 2008 and onwards, according to a report from the Danish National Board of Health. 14 As there are no private hospitals or clinics in Denmark offering ECT, 9 the information in the DNPR covers all treatments given in the country.…”

“…Descriptive statistics were used to characterize the study population after removing duplicates. 9 Since the aim of the study was to gain more insight on the use of ECT for BD in a real‐world setting, without seeking to make inferences, statistical comparisons between groups were not deemed relevant. The group of patients with incident BD not receiving ECT was only included as a reference.…”

<p>Electroconvulsive Therapy for Patients with Catatonia: Current Perspectives</p>

“…193 In Scandinavia, ECT is widely available and tends to follow updated treatment guidelines, but unequal geographic distribution can limit access. 169,194,195…”