Background: Use of electroconvulsive therapy (ECT) may have changed during the last decades due to advances in psychopharmacology and organizational changes of psychiatric care.
Objectives: To identify predictors for receiving ECT for the first time and to describe temporal trends in ECT utilization.
Methods: A register-based case-control study. The sample included 2010 cases treated with ECT between 1976 and 2000 and 148,284 controls.
Results: Predictors for receiving first ECT were unipolar affective disorders, long admissions, and no previous admissions. Significantly fewer patients with bipolar and schizoaffective disorders received the treatment in 2000 compared with 1976.
Conclusions: Unipolar affective disorders, long duration of admissions, and no history of previous admissions are strong predictors of receiving first ECT. Despite a decrease in available inpatient beds, the treatment is used in 5.5% of admissions, and during the last 15 years of the study period, ECT utilization has been remarkably stable.