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Journal of ECT:
doi: 10.1097/YCT.0b013e31824d2889
Original Studies

Electroconvulsive Therapy in Brazil After the “Psychiatric Reform”: A Public Health Problem—Example From a University Service

Ribeiro, Rafael Bernardon MD*†; Melzer-Ribeiro, Débora Luciana MSc; Rigonatti, Sérgio Paulo MD, PhD; Cordeiro, Quirino MD, PhD

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Abstract

Objectives: The Brazilian public health system does not provide electroconvulsive therapy (ECT), which is limited to a few academic services. National mental health policies are against ECT. Our objectives were to analyze critically the public policies toward ECT and present the current situation using statistics from the Institute of Psychiatry of the University of São Paulo (IPq–HCFMUSP) and summary data from the other 13 ECT services identified in the country.

Methods: Data regarding ECT treatment at the IPq–HCFMUSP were collected from January 2009 to June 2010 (demographical, number of sessions, and diagnoses). All the data were analyzed using SPSS 19, Epic Info 2000, and Excel.

Results: During this period, 331 patients were treated at IPq–HCFMUSP: 221 (67%) were from São Paulo city, 50 (15.2%) from São Paulo’s metropolitan area, 39 (11.8%) from São Paulo’s countryside, and 20 (6.1%) from other states; 7352 ECT treatments were delivered—63.0% (4629) devoted entirely via the public health system (although not funded by the federal government); the main diagnoses were a mood disorder in 86.4% and schizophrenia in 7.3% of the cases.

Conclusions: There is an important lack of public assistance for ECT, affecting mainly the poor and severely ill patients. The university services are overcrowded and cannot handle all the referrals. The authors press for changes in the mental health policies.

© 2012 by Lippincott Williams & Wilkins

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