Sociodemographic characterization of ECT utilization in Hawaii.
OBJECTIVE
Minimal research has been done on sociodemographic differences in utilization of electroconvulsive therapy (ECT) for refractory depression, especially among Asian Americans and Pacific Islanders.


METHODS
This study examined sociodemographic and diagnostic variables using retrospective data from Hawaii, an island state with predominantly Asian Americans and Pacific Islanders. Retrospective data were obtained from an inpatient and outpatient database of ECT patients from 2008 to 2010 at a tertiary care community hospital on O'ahu, Hawaii.


RESULTS
There was a significant increase in overall ECT utilization from 2008 to 2009, with utilization remaining stable from 2009 to 2010. European Americans (41%) and Japanese Americans (29%) have relatively higher rates of receiving ECT, and Filipino Americans and Native Hawaiians have relatively lower rates in comparison with their population demographics. Japanese Americans received significantly more ECT procedures than European Americans.


CONCLUSIONS
Electroconvulsive therapy is underutilized by certain sociodemographic groups that may benefit most from the treatment. There are significant differences in ECT usage based on ethnicity. Such differences may be related to help-seeking behavior, economic differences, and/or attitudes regarding mental illness. Further research is needed to elucidate the reasons for differences in utilization.
From the *Tripler Army Medical Center; †Department of Psychiatry, John A. Burns School of Medicine, University of Hawaii at Mānoa and ‡The Queen's Medical Center, Honolulu, HI.
Celia M
CM
Ona
Jane M
JM
Onoye
Deborah
D
Goebert
Earl
E
Hishinuma
R Janine
RJ
Bumanglag
Junji
J
Takeshita
Barry
B
Carlton
Michael
M
Fukuda
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001213:Asian / Q000706:statistics & numerical data; D016208:Databases, Factual; D004565:Electroconvulsive Therapy / Q000706:statistics & numerical data*; D005006:Ethnicity; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D001523:Mental Disorders / Q000628:therapy; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors; D044465:White People; D055815:Young Adult