Thompson J W, Weiner R D, Myers C P
Department of Psychiatry, University of Maryland School of Medicine, Baltimore.
Am J Psychiatry. 1994 Nov;151(11):1657-61. doi: 10.1176/ajp.151.11.1657.
The objective was to analyze nationally representative data from the National Institute of Mental Health (NIMH) to update trends in the use of ECT in the United States.
The data are estimates from the NIMH Sample Survey Program for 1975, 1980, and 1986, which include representative samples of inpatients in psychiatric facilities in the United States. The authors' analyses use trend data from public general hospitals, private general hospitals, private psychiatric hospitals, and state and county mental hospitals. They report on 126,739 patients who received ECT in 1975, 1980, and 1986, focusing on data from 1980 and 1986.
In 1986, 36,558 patients received ECT. This represents a decrease from the 1975 figure (58,667 patients) but no change from 1980 (31,514 patients). ECT was used primarily in private general hospitals (64%) and private psychiatric hospitals and much less often in public general hospitals and state and county mental hospitals. In 1986 over 90% of ECT recipients were white, and 84% had an affective disorder diagnosis. Although 71% of the patients who received ECT were women, hospital type and age were more important than gender in predicting ECT use. Individuals 65 years of age and older received ECT out of proportion to their numbers in inpatient care.
The declining use of ECT in the United States ended in the 1980s. Few African Americans receive ECT, and its use is becoming more targeted toward patients with affective disorders. The amount of services research done on this modality is very small. Basic questions have yet to be answered, including who refers patients for ECT and why, and how ECT fits into the overall course of treatment.
分析美国国立精神卫生研究所（NIMH）具有全国代表性的数据，以更新美国电休克治疗（ECT）的使用趋势。
数据来自NIMH 1975年、1980年和1986年的样本调查项目，包括美国精神病设施住院患者的代表性样本。作者的分析使用了公立综合医院、私立综合医院、私立精神病医院以及州和县立精神病医院的趋势数据。他们报告了1975年、1980年和1986年接受ECT治疗的126,739名患者，重点关注1980年和1986年的数据。
1986年，有36,558名患者接受了ECT治疗。这一数字较1975年（58,667名患者）有所下降，但与1980年（31,514名患者）相比没有变化。ECT主要用于私立综合医院（64%）和私立精神病医院，而在公立综合医院以及州和县立精神病医院使用较少。1986年，超过90%接受ECT治疗的患者为白人，84%被诊断为情感障碍。虽然接受ECT治疗的患者中有71%为女性，但在预测ECT的使用方面，医院类型和年龄比性别更为重要。65岁及以上的个体接受ECT治疗的比例与其在住院治疗中的人数不成比例。
美国ECT使用量的下降在20世纪80年代结束。很少有非裔美国人接受ECT治疗，而且其使用越来越针对情感障碍患者。针对这种治疗方式开展的服务研究数量非常少。一些基本问题尚未得到解答，包括谁将患者转诊接受ECT治疗以及原因，以及ECT如何融入整体治疗过程。
