Use of Electroconvulsive Therapy in the City of Milan

Lucca, A.; Rossini, David; Malaguti, Alessia; Zanardi, Raffaella; Magri, Lorenzo; Smeraldi, Enrico

doi:10.1097/yct.0b013e3181c18834

Cited by 3 publications

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“…Altogether, 33 studies were included from Europe and nine were from the Nordic countries. Twelve identified European studies, including one study from Italy (Lucca et al 2010), did not meet inclusion criteria (Appendix B). Surveys including a number of countries were identified from Asia (Little 2003; Chanpattana and Kramer 2004; Chanpattana et al 2010) and 15 studies from this continent were included.…”

Section: Resultsmentioning

confidence: 99%

Contemporary use and practice of electroconvulsive therapy worldwide

2012

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To explore contemporary (from 1990) utilization and practice of electroconvulsive therapy (ECT) worldwide. Systematic search (limited to studies published 1990 and after) was undertaken in the databases Medline, Embase, PsycINFO, SveMed, and EBSCO/Cinahl. Primary data‐based studies/surveys with reported ECT utilization and practice in psychiatric institutions internationally, nationally, and regionally; city were included. Two reviewers independently checked study titles and abstracts according to inclusion criteria, and extracted ECT utilization and practice data from those retrieved in full text. Seventy studies were included, seven from Australia and New Zealand, three Africa, 12 North and Latin America, 33 Europe, and 15 Asia. Worldwide ECT differences and trends were evident, average number ECTs administered per patient were eight; unmodified (without anesthesia) was used in Asia (over 90%), Africa, Latin America, Russia, Turkey, Spain. Worldwide preferred electrode placement was bilateral, except unilateral at some places (Europe and Australia/New Zealand). Although mainstream was brief‐pulse wave, sine‐wave devices were still used. Majority ECT treated were older women with depression in Western countries, versus younger men with schizophrenia in Asian countries. ECT under involuntary conditions (admissions), use of ambulatory‐ECT, acute first line of treatment, as well as administered by other professions (geriatricians, nurses) were noted by some sites. General trends were only some institutions within the same country providing ECT, training inadequate, and guidelines not followed. Mandatory reporting and overall country ECT register data were sparse. Many patients are still treated with unmodified ECT today. Large global variation in ECT utilization, administration, and practice advocates a need for worldwide sharing of knowledge about ECT, reflection, and learning from each other's experiences.

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Section: Resultsmentioning

confidence: 99%

Contemporary use and practice of electroconvulsive therapy worldwide

2012

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“…Four of these were uninformative about the long term effects on ECT recipients in general, because data beyond the treatment period were selectively reported only for those individuals who responded, or remitted, during treatment (Brakemeier et al, 2014;Lucca et al, 2010;McCall et al, 2013;Yildiz et al, 2010), Two other studies did not report whether the level of difference at follow up was statistically significant and one study did not analyze the follow up data due to small numbers (Loo et al, 2012;Loo et al, 2015;Rapinesi et al, 2013).…”

Section: Changes In Depression Beyond the Treatment Periodmentioning

confidence: 99%

“…Forty seven of the 89 were observational studies (Azuma et al, 2011;Bär et al, 2010;Bayless et al, 2010;Beall et al, 2012;Bersani et al, 2014;Bilgen et al, 2014;Burgese & Bassitt, 2015;Casarotto et al, 2013;Chiaie et al, 2013;Dannlowski et al, 2013;Dukart et al, 2014;Ebert et al, 2010;Galletly, Paterson, & Burton, 2012;Goto et al, 2012;Guloksuz et al, 2015;Hu et al, 2010;Johansson, Ehnvall, Friberg, & Myredal, 2010;Joshi et al, 2015;Kalogerakou et al, 2015;Kautto et al, 2015;Lin et al, 2013;Loo, Mahon, Katalinic, Lyndon, & Hadzi-Pavlovic, 2011;Lucca et al, 2010;Lyden et al, 2014;McCall et al, 2013;Medda et al, 2014;Meeter, Murre, Janssen, Birkenhager, & van den Broek, 2011;Minelli et al, 2014;Nickl-Jockschat et al, 2015;Nordanskog, Larsson, Larsson, & Johanson, 2014;Ota et al, 2015;Oudega et al, 2011;Perrin et al, 2012;Piccinni et al, 2013;Rapinesi et al, 2015;Rapinesi et al, 2013;Royster et al, 2012;Saijo et al, 2010;Samuelsson, Gerdin, Öllinger, & Vrethem, 2012;Tendolkar et al, ...…”

Section: Focus and Design Of The 91 Studiesmentioning

confidence: 99%

Is Electroconvulsive Therapy for Depression More Effective Than Placebo? A Systematic Review of Studies Since 2009

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Arnold

2017

Ethical Hum Psychol Psychiatry

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Is electroconvulsive therapy for depression more effective than placebo? A systematic review of studies since 2009. ABSTRACTBackground: A 2010 review of studies and previous reviews and meta-analyses found minimal evidence that ECT for depression was more effective than placebo during the treatment period and no evidence at all of efficacy beyond the end of treatment. The current review explored whether any contradictory evidence has since been generated. Method: MEDLINE and PsycINFO were searched to identify all post 2009 studies that had compared ECT and simulated ECT for depression, or had in any other way generated valid depression data for ECT recipients at two or more points in time. Results: Ninety-one studies met inclusion criteria. There were no new placebo-controlled trials. There have now been no such studies since 1985. Only four placebo-controlled studies have ever produced data beyond the end of treatment, none of which had found any advantage for ECT over placebo. Of the 91 studies only two aimed to evaluate the efficacy of ECT. Both were severely flawed. None of the other 89 produced robust evidence that ECT is effective for depression, primarily because at least 60% maintained ECT participants on medication and 89% produced no meaningful follow up data beyond the end of treatment. No studies investigated whether ECT prevents suicide. Conclusions: There is still no evidence that ECT is more effective than placebo for depression reduction or suicide prevention. Given the 1 well-documented high risk of persistent memory dysfunction, the cost-benefit analysis for ECT remains so poor that its use cannot be scientifically, or ethically, justified.

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