Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-25T06:28:26.601Z Has data issue: false hasContentIssue false
  • English
  • Français

Audit of Electroconvulsive Treatment in two National Health Service Regions

Published online by Cambridge University Press:  02 January 2018

John Pippard
John Pippard*
Affiliation:
Research Unit, Royal College of Psychiatrists
*
9 Princes Avenue, Woodford Green, Essex IG8 0LL
Get access Rights & Permissions [Opens in a new window]

Abstract

The practice of ECT has been surveyed by visits to all 35 NHS hospitals and five private clinics where it is used in the North East Thames and East Anglian Regions, and observation of ECT administration in 29 NHS and two private clinics. Since 1981 there has been much improvement in the physical conditions in which ECT is given and in anaesthetic practice. Nursing is good or excellent in a majority. About half the clinics have the most effective Ectron constant-current series 5 apparatus; the rest have older models with which ‘missed’ fits and undertreatment are frequent. Stimulus-dosing is usually by habit rather than rational strategy, and routine instrument settings differ fourfold between clinics. Most hospitals have nominated consultants in charge of ECT, but few of these are closely involved and little has changed in the unsatisfactory training and supervision of those who give the treatment. The use of ECT has fallen by 55% in North East Thames Region since 1979, but has risen by 20% in the East Anglian Region. There are up to 12–fold differences in usage between districts.

Type
Papers
Information
The British Journal of Psychiatry , Volume 160 , Issue 5 , May 1992 , pp. 621 - 637
Copyright
Copyright © The Royal College of Psychiatrists, 1992 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1990) Task Force on ECT: The Practice of ECT: Recommendations for Treatment, Training and Privileging. Washington, DC: APA. (Summary of recommendations in Convulsive Therapy (1990), 6, 85–120.) Google Scholar
Department of Health and Social Security (1982) Electroconvulsive Therapy Equipment. Report of a Working Party (Shenolikar, B. K. Chairman). London: DHSS Google Scholar
Hospital & Health Services Year Book (1990) London: Institute of Health Services Management Google Scholar
Idle, M. (1991) Observer, 5 May.Google Scholar
Latey, R. H. & Fahy, T. J. (1985) Electroconvulsive Therapy in the Republic of Ireland, 1982. Galway: Galway University Press.Google Scholar
Ottosson, J.-O. (1960) Experimental studies of the mode of action of electroconvulsive therapy. Acta Psychiatrica Scandinavica (suppl. 145).Google Scholar
Pippard, J. & Ellam, L. (1981) Electroconvulsive Treatment in Great Britain, 1980. London: Gaskell Google Scholar
Pippard, J. & Ellam, L. (1981) Electroconvulsive treatment in Great Britain. British Journal of Psychiatry, 139, 563–568.CrossRefGoogle ScholarPubMed
Pippard, J. (1988) ECT custom and practice. Psychiatric Bulletin, 12, 473–475.Google Scholar
Royal College Of Nursing (1982) Nursing Guidelines for ECT. London: Royal College of Nursing.Google Scholar
Royal College of Psychiatrists (1977) Memorandum on the use of electroconvulsive therapy. British Journal of Psychiatry, 131, 261–272.Google Scholar
Royal College of Psychiatrists (1989) The Practical Administration of Electroconvulsive Therapy. London: Gaskell.Google Scholar
Sackeim, H. A., Devanand, D. P. & Prudic, J. (1992) Stimulus intensity, seizure threshold, and seizure duration: impact on the efficacy and safety of electroconvulsive therapy. Psychiatric Clinics of North America (in press).Google Scholar
Scott, A. I. F., Shering, P. A. & Dykes, S. (1989) Would monitoring by electroencephalogram improve the practice of electroconvulsive therapy? British Journal of Psychiatry, 154, 853–857.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.