The rate of usage of electroconvulsive therapy in the city of Edinburgh, 1993-2005.
BACKGROUND
In May 2003, the National Institute for Clinical Excellence published controversial clinical guidelines that intended to restrict the indications for the use of electroconvulsive therapy (ECT) in the United Kingdom.


OBJECTIVE
We investigated whether the guideline had affected the rate of usage of ECT in the City of Edinburgh and set this in the context of ECT usage in the City since 1993.


METHODS
We calculated the annual rate of ECT usage using a case register and contemporaneous and coterminous population data, reporting separately rates for young people (younger than 18 years), the general adult population, and older adults (aged 65 years of age and older).


RESULTS
No young person was treated after 1998. There were similar significant falls in the rates of usage in both the general adult and older age population (-60%). There was no suggestion that the fall had accelerated after May 2003.


CONCLUSIONS
No early effect of the guidance was found in the rate of ECT usage in the City of Edinburgh, but the passage of time will be required to assess any longer term effect.
Royal Edinburgh Hospital, Edinburgh, Scotland, UK.
Nkiruka
N
Okagbue
Andrew
A
McIntosh
Morag
M
Gardner
Allan I F
AI
Scott
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D004565:Electroconvulsive Therapy / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012606:Scotland; D055815:Young Adult