title: A Further Decrease in the Rates of Administration of Electroconvulsive Therapy in England.
abstract: OBJECTIVE
  Electroconvulsive therapy (ECT) is an effective treatment of major depression, and there have been consistent improvements in the administration of ECT in the past decade. However, studies have reported a steady decline in the rates of use of ECT in the United Kingdom and Ireland. Despite this, there has been no consistent record of how much ECT is being given or to whom it is given, for more than 20 years. The purpose of this study is to estimate the change in frequency of ECT use, the length of courses, patient demographics, and clinical outcomes between 2006 and 2 periods of 2012/2013 and 2014/2015.
  
  
  METHODS
  In 2012/2013, clinics were asked to complete an online survey giving details of every patient who started a course of ECT between April 1, 2012, and March 31, 2013. This was repeated for the same period in 2014/2015.
  
  
  RESULTS
  There continues to be a striking decline in the number of courses of ECT prescribed. Course length has increased. Women are twice as likely to be prescribed ECT as men. Modal age is 60 to 80 years, and the most common diagnosis is depression. Most courses were rated as clinically effective, especially for people with severe illnesses. Maintenance ECT is used at half the clinics surveyed.
  
  
  CONCLUSIONS
  The use of ECT in England continues to decline. The reasons for this are unclear and need investigation.
authors.affiliation: From the *Centre for Quality Improvement, Royal College of Psychiatrists, London; and †Oxford Health NHS Foundation Trust, Oxford, United Kingdom.
authors.forename: Nicky
authors.initials: N
authors.lastname: Buley
authors.forename: Emma
authors.initials: E
authors.lastname: Copland
authors.forename: Sophie
authors.initials: S
authors.lastname: Hodge
authors.forename: Robert
authors.initials: R
authors.lastname: Chaplin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000628:therapy; D003865:Major Depressive Disorder / Q000628:therapy; D004565:Electroconvulsive Therapy / Q000706:statistics & numerical data* / Q000639:trends*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy; D008875:Middle Aged; D012737:Sex Factors; D013222:State Medicine; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology