Place of electroconvulsive therapy in the treatment of depression in France: A comparative study between clinical practice and international recommendations

Abstract

ObjectivesTo study the place of electroconvulsive therapy (ECT) in the treatment of major depressive disorder in France and compare it with international recommendations and algorithms.MethodMulticenter, retrospective study in 12 French university hospitals. Diagnosis, delay between the onset of the episode and the first day of ECT, previous treatments have been identified. Only patients treated for major depressive disorder between 1 January 2009 and 1 January 2014 were included.ResultsA total of 754 patients were included (middle age 61.07 years, sex ratio 0.53). The diagnoses listed were: first major depressive episode (14.95%), bipolar depression (38.85%) and unipolar recurrent depression (46.19%). The delay before ECT, was 11.01 months (13,98), and was significantly longer for first episodes (16.45 months, P < 0.001) and shorter in case of psychotic symptoms (8.76 months, P < 0.03) and catatonic symptoms (6.70, P < 0.01).ConclusionsThe delay before ECT appears on average, four times longer than recommended by treatment algorithms for the management of major depressive disorder. This long delay could be explained by a very heterogeneous access to this treatment in French territory.Disclosure of interestThe authors have not supplied their declaration of competing interest.