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Psychiatric Bulletin (2003) 27: 137-140. doi: 10.1192/pb.27.4.137
© 2003 The Royal College of Psychiatrists
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Psychiatric Bulletin (2003) 27: 137-140
© 2003 The Royal College of Psychiatrists

Do patients who receive electroconvulsive therapy in Scotland get better?

Results of a national audit

Grace Fergusson, Associate Specialist

Argyll and Bute Hospital, Lochgilphead, Argyll PA31 8LD

James Hendry, Associate Medical Director

West Lothian Healthcare NHS Trust, Bangour Village Hospital, West Lothian EH52 6LN

Chris Freeman, Consultant Psychiatrist

Tipperlin House, Royal Edinburgh Hospital, Edinburgh EH10 5HF

The audit was funded by a grant from the Clinical Resource and Audit Group of the Scottish Executive Health Department.

AIMS AND METHOD

We aimed to compare the practice of electroconvulsive therapy (ECT) in Scotland with the recommendations of the Royal College of Psychiatrists, to determine the characteristics of patients who receive ECT, to assess the outcome of ECT given in a routine clinical setting and to develop a system of quality assurance for ECT. Between February 1997 and March 2000, an audit of ECT measured the quality of treatment given at all clinics in Scotland. Audit tools were designed and standards set for the process, and outcome of treatment and interventions were identified to address any variance prior to each audit cycle. An electronic data collection system was developed and a website produced for the purpose of continued audit and information sharing.

RESULTS

The annual rate of ECT in Scotland was 142 individual treatments per 100 000 of the total population. Electroconvulsive therapy was given mainly to White adult patients with a depressive illness who had consented to treatment. Clinical improvement, as measured by at least a 50% reduction in the Montgomery—Åsberg Rating Scale for Depression (MADRS) score, was evident in 71.2% of patients with a depressive episode.

CLINICAL IMPLICATIONS

The audit of ECT is achievable at a national level, ECT is effective in a routine clinical setting and the standards at ECT in Scotland are higher than the UK average.







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British Journal of Psychiatry Advances in Psychiatric Treatment All RCPsych Journals
Copyright © 2003 The Royal College of Psychiatrists.