title: Use of electroconvulsive therapy for Asian patients with schizophrenia (2001-2009): Trends and correlates.
abstract: OBJECTIVE
  Little is known about electroconvulsive therapy (ECT) use in Asian inpatients with schizophrenia. This study examined trends of ECT use for schizophrenia patients in Asia between 2001 and 2009 and its independent demographic and clinical correlates.
  
  
  METHODS
  Data on 6761 hospitalized schizophrenia patients (2001 = 2399, 2004 = 2136, and 2009 = 2226) in nine Asian countries and territories were collected by either chart review or interviews during a 1-month period. Patients' sociodemographic and clinical characteristics, prescriptions of psychotropic drugs and ECT use were recorded using a standardized protocol and data-collection procedure.
  
  
  RESULTS
  The frequency of ECT was 3.3% in the whole sample; rising from 1.8% in 2001 to 3.3% in 2004 and 4.9% in 2009 (P < 0.0001). However, this increased trend was driven solely by increased ECT use in China (P < 0.0001), and the inclusion of India in the 2009 survey. There were wide inter-country variations: 2001, 0% (Hong Kong, Korea) to 5.9% (China); 2004, 0% (Singapore) to 11.1% (China); 2009, 0% (Hong Kong) to 13.8% (India) and 15.2% (China). Multiple logistic regression analysis of the whole sample revealed that patients receiving ECT were less likely in the 35-64-year age group, had shorter length of current hospitalization and fewer negative symptoms, and were more likely to receive second-generation antipsychotic medications compared to those who were not treated with ECT (R(2)  = 0.264, P < 0.001).
  
  
  CONCLUSIONS
  ECT use for schizophrenia has increased over the past decade in China, being low/relatively stable in other Asian countries/regions. Reasons for substantial variations in ECT frequency in Asia require further study.
authors.affiliation: Faculty of Health Sciences, University of Macau, Macao, China.|Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Yu-Tao
authors.initials: YT
authors.lastname: Xiang
authors.affiliation: School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia.|University of Notre Dame Australia, Perth, Australia.
authors.forename: Gabor S
authors.initials: GS
authors.lastname: Ungvari
authors.affiliation: Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, USA.
authors.forename: Christoph U
authors.initials: CU
authors.lastname: Correll
authors.affiliation: Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Helen F K
authors.initials: HF
authors.lastname: Chiu
authors.affiliation: Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Kelly Y C
authors.initials: KY
authors.lastname: Lai
authors.affiliation: Beijing Anding Hospital, Capital Medical University, Beijing, China.
authors.forename: Chuan-Yue
authors.initials: CY
authors.lastname: Wang
authors.affiliation: Key Laboratory of Mental Health, Ministry of Mental Health & Peking University Institute of Mental Health, Beijing, China.
authors.forename: Tian-Mei
authors.initials: TM
authors.lastname: Si
authors.affiliation: Department of Psychiatry, University of Hong Kong, Hong Kong, China.
authors.forename: Edwin H M
authors.initials: EH
authors.lastname: Lee
authors.affiliation: Shanghai Mental Health Center, Shanghai, China.
authors.forename: Yan-Ling
authors.initials: YL
authors.lastname: He
authors.affiliation: Taipei City Hospital, Taipei, Taiwan.
authors.forename: Shu-Yu
authors.initials: SY
authors.lastname: Yang
authors.affiliation: Kaohsiung Chang Gung Memorial Hospital and School of Medicine, Chang Gung University, Chang Gung, Taiwan.
authors.forename: Mian-Yoon
authors.initials: MY
authors.lastname: Chong
authors.affiliation: Department of Psychological Medicine, National University of Singapore, Singapore, Japan.
authors.forename: Ee-Heok
authors.initials: EH
authors.lastname: Kua
authors.affiliation: Fukushima Medical University, Fukushima, Japan.
authors.forename: Senta
authors.initials: S
authors.lastname: Fujii
authors.affiliation: Institute of Mental Health, Buangkok View, Singapore, Japan.
authors.forename: Kang
authors.initials: K
authors.lastname: Sim
authors.affiliation: Institute of Mental Health, Buangkok View, Singapore, Japan.
authors.forename: Michael K H
authors.initials: MK
authors.lastname: Yong
authors.affiliation: Department of Psychiatry, C. S. M. Medical University UP, Lucknow, India.
authors.forename: Jitendra K
authors.initials: JK
authors.lastname: Trivedi
authors.affiliation: Department of Psychiatry, National Seoul Hospital, Seoul, Korea.
authors.forename: Eun-Kee
authors.initials: EK
authors.lastname: Chung
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
authors.forename: Pichet
authors.initials: P
authors.lastname: Udomratn
authors.affiliation: Department of Psychiatry and Mental Health, Tunku Abdul Rahman Institute of Neuroscience, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia.
authors.forename: Kok-Yoon
authors.initials: KY
authors.lastname: Chee
authors.affiliation: Association for the Improvement of Mental Health Programs, Geneva, Switzerland.
authors.forename: Norman
authors.initials: N
authors.lastname: Sartorius
authors.affiliation: Department of Pharmacology, National University of Singapore, Singapore, Japan.
authors.forename: Chay-Hoon
authors.initials: CH
authors.lastname: Tan
authors.affiliation: School of Human Sciences, Seinan Gakuin University, Fukuoka, Japan.
authors.forename: Naotaka
authors.initials: N
authors.lastname: Shinfuku
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001208:Asia; D044466:Asian People / Q000706:statistics & numerical data*; D003131:Combined Modality Therapy / Q000639:trends; D004565:Electroconvulsive Therapy / Q000706:statistics & numerical data* / Q000639:trends*; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012559:Schizophrenia / Q000188:drug therapy / Q000628:therapy*
chemical_list: D014150:Antipsychotic Agents
keywords: Asia; electroconvulsive therapy; inpatients; schizophrenia