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Delivery of Electroconvulsive Therapy in Canada: A First National Survey Report on Devices and Technique

Gosselin, Caroline MD, FRCPC; Graf, Peter PhD; Milev, Roumen MD, FRCPC; Delva, Nicholas MD, FRCPC; Lawson, James Stuart PhD; Enns, Murray MD, FRCPC; Gilron, Ian MD, FRCPC; Martin, Barry MD, FRCPC; Chan, Peter MD, FRCPC; Patry, Simon MD, FRCPC; Jewell, Mark BA, RPN

doi: 10.1097/YCT.0b013e31827f135b
Original Studies

Objective Electroconvulsive therapy (ECT) is an effective treatment for mood and other psychiatric disorders. Despite widespread use, the specifics of ECT practice in Canada are largely unknown. A nationwide survey designed to document current delivery was therefore conducted.

Method One hundred seventy-five Canadian ECT delivery sites were identified. A detailed questionnaire (13 pages, 76 questions grouped in 11 subheadings) was developed, translated into French, piloted, and then forwarded to all ECT centers.

Results Return rate for the full questionnaire was 61%. Wide-ranging information pertaining to ECT was gathered. This article, which addresses the data specifically pertaining to ECT devices, electrical stimulus parameters and electrode placements, showed that many core aspects of ECT practice in Canada are in keeping with current recommendations. The use of old sine wave devices is virtually nonexistent. Electroencephalographic (EEG) monitoring of seizures is widespread.

Conclusions Specific concerns were identified, including the need for access to back-up devices at all centers, the lack of ECT credentialing requirements by Canadian hospitals, and a striking variation in dosing practices. An audit of Canadian practice and the development of a National Standards Document would be an essential next undertaking.

From the Departments of *Psychiatry and †Psychology, University of British Columbia (UBC), Vancouver; ‡Departments of Psychiatry and Psychology, Queen’s University, Kingston; §Department of Psychiatry, Dalhousie University,Halifax; ∥Department of Psychiatry, Queen’s University, Kingston ¶Department of Psychiatry, University of Manitoba, Winnipeg; #Departments of Anesthesiology and Perioperative Medicine and Biomedical and Molecular Sciences, Queen’s University, Kingston; **Department of Psychiatry, University of Toronto, Toronto; ††Department of Psychiatry, UBC, Vancouver; ‡‡Department of Psychiatry, Laval University, Quebec City and §§Addiction and Mental Health, Alberta Health Services, Edmonton, Canada.

Received for publication July 22, 2012; accepted November 20, 2012.

Reprints: Caroline Gosselin, MD, FRCPC, University of British Columbia (UBC), and Director of Continuing Professional Development, CP5D, Vancouver General Hospital, 855 West 12th Ave, Vancouver, BC, Canada V5Z 1M9 (e-mail:

Funding for this study was provided by the Vancouver Coastal Health Authority, which had no further role in any aspect of the conduct of the study.

The authors have no conflicts of interest or financial disclosures to report.

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