title: Trends in use of electroconvulsive therapy in South London from 1949 to 2006.
abstract: OBJECTIVE
  Electroconvulsive therapy (ECT) remains the most acutely effective treatment for severe depression, but its use has declined since its introduction more than 70 years ago. To provide some historical perspective on changes in ECT practice, the objective of the present study was to identify trends in ECT practice in selected teaching hospitals in South London, UK, between 1949 and 2006.
  
  
  METHODS
  Annual rates of ECT for 1949-1970 were estimated from the contemporary hospital reports of the Maudsley and Bethlem Royal hospitals in South London, UK. Case notes were also retrospectively reviewed to calculate annual rates of ECT administration and extract demographic and clinical information for approximately every 5 years between 1987 and 2006.
  
  
  RESULTS
  The annual rate of ECT peaked at 35% of total admission in 1956 and declined gradually thereafter to 10.8% by 1970 and fell below 2.2% from 1991 onward. Depressed and female patients were more likely to receive ECT. Compared to previous years, patients were more severely ill and treatment resistant in 2006, whereas ethnic minorities made up 30% of patients receiving ECT compared to approximately 14% in the preceding years.
  
  
  CONCLUSIONS
  Currently, ECT seems to be provided increasingly late in more severe illness episodes. The ethnicity of patients receiving ECT in South London may be becoming more representative of the background population, but ECT is being used relatively more frequently for nonaffective disorders in ethnic minorities.
authors.affiliation: From the *Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland; and †Section of Old Age Psychiatry, Institute of Psychiatry, King's College London, De Crespigny Park, London, UK.
authors.forename: Sinéad
authors.initials: S
authors.lastname: Lambe
authors.forename: Andrew
authors.initials: A
authors.lastname: Mogg
authors.forename: Savitha
authors.initials: S
authors.lastname: Eranti
authors.forename: Graham
authors.initials: G
authors.lastname: Pluck
authors.forename: Sarah
authors.initials: S
authors.lastname: Hastilow
authors.forename: Declan M
authors.initials: DM
authors.lastname: McLoughlin
mesh_terms: D000328:Adult; D000368:Aged; D003865:Major Depressive Disorder / Q000628:therapy; D004565:Electroconvulsive Therapy / Q000266:history* / Q000639:trends*; D005006:Ethnicity; D005260:Female; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D016896:Treatment Outcome