Li Wei, Hu Na, Gao Xiaoxiao, Song Yanying, Zhang Rongzhen, Sun Shiyou, Tong Jinghui, Shen Yang, Yu Yongjun, Yang Kebing, Chen Yan, Song Jiaqi
Beijing Huilongguan Hospital, Beijing, China.
Huilongguan Clinical Medical School, Peking University, Beijing Huilongguan Hospital, Beijing, China.
Front Psychiatry. 2025 Jun 3;16:1508044. doi: 10.3389/fpsyt.2025.1508044. eCollection 2025.
Recent studies on electroconvulsive therapy (ECT) have reported inconsistent frequencies of ECT use in various countries. Therefore, this study aimed to investigate the trends of ECT use in a large psychiatric center in China over 6 consecutive years.
A total of 22,120 inpatients, aged 18-59 years, admitted during the period 2015-2020 to a large grade-A tertiary psychiatric center in Beijing were enrolled in this retrospective study. Demographic and clinical data including vital signs; daily living abilities(ADL); emergency referrals; psychiatric and physical prescriptions were collected from an electronic medical records system.
In all, 2,213 (10.0%) inpatients received ECT, with an average number of sessions of 10.3 ± 6.6. There were no significant differences between the ECT and non-ECT groups in terms of educational level, marital status, length of hospital stay, and blood pressure. After using the propensity score matching (PSM) method, Multiple logistic regression analysis revealed that ECT use was independently associated with married/cohabitating (OR = 1.21, 95% CI: 1.03-1.43); few hospitalizations (OR = 0.96, 95% CI: 0.93-0.99); unemployed (OR = 1.43, 95% CI: 1.16-1.76); emergency referral (OR = 1.62, 95% CI: 1.36-1.93); increased use of antipsychotics (OR = 2.63, 95% CI: 1.88-3.68), mood stabilizers (OR = 1.30, 95% CI: 1.01-1.67), antidepressants (OR = 1.40, 95% CI: 1.13-1.73), and trihexyphenidyl (OR = 1.30, 95% CI: 1.05-1.50); reduced use of hypoglycemic drugs (OR = 0.64, 95% CI: 0.45-0.83); fast heart rate (OR = 1.01, 95% CI: 1.01-1.02); and severe impairments in ADL. Compared with that in 2015 (13.2%), ECT use decreased annually from 2016 (12.4%) to 2019 (9.6%), especially in 2020 (5.7%), given the impact of the COVID-19 pandemic in China.
The ECT usage and year-by-year decrease in ECT use in this study were consistent with the recent trends in other regions. Patients with the married/cohabitating, unemployed, and emergency-referral, unstable vital signs, more severe disability received ECT for quick alleviation of their conditions.
近期关于电休克治疗（ECT）的研究报告了不同国家ECT使用频率不一致的情况。因此，本研究旨在调查中国一家大型精神病中心连续6年的ECT使用趋势。
本回顾性研究纳入了2015年至2020年期间在北京一家大型三级甲等精神病中心收治的22120例年龄在18至59岁之间的住院患者。从电子病历系统中收集人口统计学和临床数据，包括生命体征、日常生活能力（ADL）、急诊转诊、精神科和物理治疗处方。
共有2213例（10.0%）住院患者接受了ECT治疗，平均治疗次数为10.3±6.6次。ECT组和非ECT组在教育水平、婚姻状况、住院时间和血压方面无显著差异。使用倾向评分匹配（PSM）方法后，多因素logistic回归分析显示，ECT治疗与已婚/同居（OR = 1.21，95%CI：1.03 - 1.43）、住院次数少（OR = 0.96，95%CI：0.93 - 0.99）、失业（OR = 1.43，95%CI：1.16 - 1.76）、急诊转诊（OR = 1.62，95%CI：1.36 - 1.93）、抗精神病药物使用增加（OR = 2.63，95%CI：1.88 - 3.68）、心境稳定剂使用增加（OR = 1.30，95%CI：1.01 - 1.67）、抗抑郁药物使用增加（OR = 1.40，95%CI：1.13 - 1.73）、苯海索使用增加（OR = 1.30，95%CI：1.05 - 1.50）、降糖药物使用减少（OR = 0.64，95%CI：0.45 - 0.83）、心率快（OR = 1.01，95%CI：1.01 - 1.02）以及ADL严重受损独立相关。与2015年（13.2%）相比，2016年（12.4%）至2019年（9.6%）ECT使用率逐年下降，尤其是在2020年（5.7%），这是由于中国新冠疫情的影响。
本研究中ECT的使用情况及其逐年下降趋势与其他地区的近期趋势一致。已婚/同居、失业、急诊转诊、生命体征不稳定、残疾程度更严重的患者接受ECT以迅速缓解病情。
