Wood Debra A, Burgess Philip M
Outer East Area Mental Health Services, Maroondah Hospital, PO Box 135, Ringwood East, Victoria 3135, Australia.
Aust N Z J Psychiatry. 2003 Jun;37(3):307-11. doi: 10.1046/j.1440-1614.2003.01182.x.
To determine the population-based utilization rate of electroconvulsive therapy (ECT) in Victoria between 1998-1999, to examine the characteristics of the ECT treated group, and to identify patient factors independently associated with differential rates of ECT treatment.
Electroconvulsive therapy is reported under statute in Victoria, Australia. Crude, age-adjusted and age-sex specific utilization rates were calculated using this statutory data for the 1998-1999 financial year and estimated mid-year populations from the Australian Bureau of Statistics. Descriptive characteristics of those treated with ECT were derived from the statutory data. Patient factors associated with an increased likelihood of ECT in the public sector were explored with logistic regression analysis, using non-ECT treated mental health patients from the Victorian Psychiatric Case Register as the reference population.
The crude treated-person and age-adjusted rates for the State (both public and private sectors) were 39.9 and 44.0 persons per 100 000 resident population per annum, respectively. The crude and age-adjusted administration rates were 330.3 and 362.6 ECT administrations per 100 000 resident population per annum, respectively. Age-sex specific rates varied by age and sex, with rates generally increasing with age and female sex. Overall, 62.8% of the treated group were women, 32.9% aged over 64, and 75.2% had depression. Diagnosis, age and sex each independently predicted ECT in the public sector, with diagnosis the most important factor, followed by age then sex.
Despite decades of use, the appropriate rate of ECT utilization is still unclear. Further research should be directed at exploring the factors, including provider variables, determining ECT treatment.
确定1998 - 1999年维多利亚州基于人群的电休克治疗（ECT）使用率，研究接受ECT治疗组的特征，并确定与ECT治疗差异率独立相关的患者因素。
在澳大利亚维多利亚州，ECT治疗需依法上报。利用该法定数据以及澳大利亚统计局估计的年中人口数据，计算了1998 - 1999财政年度的粗使用率、年龄调整使用率和年龄 - 性别特异性使用率。接受ECT治疗者的描述性特征来自法定数据。以维多利亚州精神病病例登记册中未接受ECT治疗的精神卫生患者作为对照人群，通过逻辑回归分析探索与公共部门中接受ECT治疗可能性增加相关的患者因素。
该州（公共和私营部门）的粗治疗人数率和年龄调整率分别为每年每10万居民人口39.9人和44.0人。粗给药率和年龄调整给药率分别为每年每10万居民人口330.3次和362.6次ECT给药。年龄 - 性别特异性率因年龄和性别而异，总体上随年龄增长和女性而增加。总体而言，治疗组中62.8%为女性，32.9%年龄超过64岁，75.2%患有抑郁症。诊断、年龄和性别在公共部门均独立预测ECT治疗，其中诊断是最重要的因素，其次是年龄，然后是性别。
尽管ECT已使用数十年，但其适当的使用率仍不明确。应进一步开展研究，探索包括提供者变量在内的决定ECT治疗的因素。
