title: Electroconvulsive Therapy at a Veterans Health Administration Medical Center.
abstract: OBJECTIVE
  Little epidemiologic research has examined the practice of electroconvulsive therapy (ECT). We investigated sociodemographic and clinical characteristics, service use, and psychotropic medication prescription patterns associated with ECT use at a Veterans Health Administration Medical Center.
  
  
  METHODS
  Among veterans receiving specialty mental health services, we compared those who received ECT with those who did not using bivariate χ and t tests and multivariate logistic regression.
  
  
  RESULTS
  In fiscal year 2012, 11,117 veterans received specialty mental health services, of whom 50 received ECT (0.45%) in FY2012 or FY2013. Those who received ECT were more likely to be diagnosed with major depressive or bipolar disorders and had substantially higher levels of mental health service usage (Cohen d > 0.75) and psychotropic prescription fills, including antidepressants (Cohen d = 2.66), antipsychotics (Cohen d = 2.15), lithium (Cohen d = 1.34), mood stabilizers (Cohen d = 1.30), and anxiolytic/sedative/hypnotics (Cohen d = 1.34).
  
  
  CONCLUSIONS
  Our findings suggest that ECT is used as a treatment of last resort, although available evidence and guidelines recommend wider use.
authors.forename: Samuel T
authors.initials: ST
authors.lastname: Wilkinson
authors.forename: Robert A
authors.initials: RA
authors.lastname: Rosenheck
mesh_terms: D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000453:epidemiology / Q000628:therapy; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000628:therapy; D004363:Drug Utilization; D004565:Electroconvulsive Therapy / Q000706:statistics & numerical data*; D005260:Female; D006787:Hospitals, Veterans / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000627:therapeutic use; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans
chemical_list: D011619:Psychotropic Drugs