Dennis Paul A, Thomas Shaun N, Husain Mustafa M, Dennis Nora M
University of Texas Southwestern Medical Center, Dallas, TX.
J ECT. 2019 Jun;35(2):103-105. doi: 10.1097/YCT.0000000000000555.
Electroconvulsive therapy (ECT) is a treatment of choice for severe depression but has been underutilized among black patients. This study investigates racial disparities in the administration of ECT in the state of Texas between 1998 and 2013 using population data.
Data from the Texas Department of State Health Services were obtained corresponding to the use for all ECT conducted in nonfederal settings during the period from January 2, 1998, to August 30, 2013. The data set comprised quarterly reports generated for each patient, totaling 27,931 patient quarters. Using year-by-year intercensal population estimates for the state of Texas, ECT treatments per capita were compared among black, white, Latina/Latino, and other individuals during this time period.
Significantly more white patients were treated each quarter than minority patients (P < 0.001), with Latina/Latino patients recording fewer treatment quarters than any other racial group (P < 0.005). Large discrepancies in diagnosis by race were observed. Black patients were less likely than white and Latina/Latino patients to be diagnosed with depression and 4 times as likely as white patients to carry a diagnosis of schizophrenia.
Concordant with previous data, large racial disparities in the administration of ECT were found in this Texas data set. Despite the limited nature of this data set, these results suggest that continued investigation is required to determine factors responsible for these disparities.
电休克疗法（ECT）是治疗重度抑郁症的首选方法，但在黑人患者中使用不足。本研究利用人口数据调查了1998年至2013年德克萨斯州ECT治疗中的种族差异。
获取了德克萨斯州州立卫生服务部的数据，这些数据对应于1998年1月2日至2013年8月30日期间在非联邦机构进行的所有ECT治疗的使用情况。数据集包括为每位患者生成的季度报告，共计27931个患者季度。利用德克萨斯州逐年的人口普查间估计数据，比较了这段时间内黑人、白人、拉丁裔和其他人群的人均ECT治疗情况。
每季度接受治疗的白人患者明显多于少数族裔患者（P < 0.001），拉丁裔患者的治疗季度数少于任何其他种族群体（P < 0.005）。观察到不同种族在诊断上存在巨大差异。黑人患者被诊断为抑郁症的可能性低于白人和拉丁裔患者，而被诊断为精神分裂症的可能性是白人患者的4倍。
与之前的数据一致，在这个德克萨斯州的数据集中发现ECT治疗存在巨大的种族差异。尽管该数据集性质有限，但这些结果表明需要继续进行调查，以确定造成这些差异的因素。
