title: Pattern of electroconvulsive therapy use in Spain: Proposals for an optimal practice and equitable access.
abstract: OBJECTIVE
  The main aims of our study were to estimate the current rates and pattern of electroconvulsive therapy (ECT) use in Spain, as well as exploring the causes that may be limiting its use in our country.
  
  
  METHODS
  A cross-sectional survey was conducted covering every psychiatric unit in Spain as of 31 December 2012.
  
  
  RESULTS
  More than half (54.9%) of the psychiatric units applied ECT at a rate of 0.66 patients per 10,000 inhabitants. There are wide variations with regard to ECT application rates between the different autonomous communities (0.00-1.39) and provinces (0.00-3.90). ECT was prescribed to a mean of 25.5 patients per hospital that used the technique and 4.5 in referral centre (P=.000), but wide differences were reported in the number of patients who were prescribed ECT from hospital to hospital.
  
  
  CONCLUSIONS
  Although the percentage of psychiatric units applying ECT in our country is among the highest in the world, the ECT application rate in Spain is among the lowest within western countries. Large differences in ECT use have been reported across the various autonomous communities, provinces and hospitals. Thus, health planning strategies need to be implemented, as well as promoting training in ECT among health professionals, if these differences in ECT use are to be reduced.
authors.affiliation: Hospital Universitario 12 de Octubre, Instituto de Investigación 12 de Octubre, Madrid, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), España. Electronic address: fjavisanzf@gmail.com.
authors.forename: Javier
authors.initials: J
authors.lastname: Sanz-Fuentenebro
authors.affiliation: Hospital Universitario Infanta Cristina, Parla, Madrid, España.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Vera
authors.affiliation: Fundación Jiménez Díaz, Madrid, España.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Verdura
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), España; Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España.
authors.forename: Mikel
authors.initials: M
authors.lastname: Urretavizcaya
authors.affiliation: Corporació Sanitària-Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Barcelona, España.
authors.forename: Erika
authors.initials: E
authors.lastname: Martínez-Amorós
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), España; Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España.
authors.forename: Virginia
authors.initials: V
authors.lastname: Soria
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), España; Hospital Clínic Universitari de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, España.
authors.forename: Miquel
authors.initials: M
authors.lastname: Bernardo
mesh_terms: D003430:Cross-Sectional Studies; D004565:Electroconvulsive Therapy / Q000592:standards / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000592:standards / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011567:Psychiatric Department, Hospital; D013030:Spain
keywords: Electroconvulsive therapy; Encuesta; Epidemiology; Epidemiología; España; Spain; Survey; Terapia electroconvulsiva