Electroconvulsive Therapy at a Veterans Health Administration Medical Center

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ObjectivesLittle epidemiologic research has examined the practice of electroconvulsive therapy (ECT). We investigated sociodemographic and clinical characteristics, service use, and psychotropic medication prescription patterns associated with ECT use at a Veterans Health Administration Medical Center.MethodsAmong veterans receiving specialty mental health services, we compared those who received ECT with those who did not using bivariate χ2 and t tests and multivariate logistic regression.ResultsIn fiscal year 2012, 11,117 veterans received specialty mental health services, of whom 50 received ECT (0.45%) in FY2012 or FY2013. Those who received ECT were more likely to be diagnosed with major depressive or bipolar disorders and had substantially higher levels of mental health service usage (Cohen d > 0.75) and psychotropic prescription fills, including antidepressants (Cohen d = 2.66), antipsychotics (Cohen d = 2.15), lithium (Cohen d = 1.34), mood stabilizers (Cohen d = 1.30), and anxiolytic/sedative/hypnotics (Cohen d = 1.34).ConclusionsOur findings suggest that ECT is used as a treatment of last resort, although available evidence and guidelines recommend wider use.

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