Portugal is treating few people with psychiatric illness using electroconvulsive therapy (ECT), popularly known as “electroshock”, when compared to other European countries.
An investigation by the Faculty of Medicine of the University of Porto (FMUP), CINTESIS – Center for Health Technology and Services Research, and the Tâmega e Sousa Hospital Center (CHTS) has assessed, for the first time, the use of electroshock in people with psychiatric illness admitted to public hospitals nationwide.
The study concludes that treatment with “electroshock” is underused in our country, despite being “fast, safe and effective” for a range of psychiatric disorders.
“Thanks to anesthesia and current devices, electroconvulsive therapy under anesthesia is painless for patients and is one of the safest treatments available,” explains Manuel Gonçalves Pinho, a researcher at CINTESIS/FMUP and author of the study. Besides being safe, this treatment is very effective, particularly in antidepressant-resistant depression, reaching response rates of 80 to 90%.
In this unprecedented study, published in the international journal The Journal of Electroconvulsive Therapy (ECT), 674 patients treated with electroshock between 2008 and 2015 in Portuguese public hospitals were identified. In all, 879 hospitalizations were registered. Major depression was the main diagnosis (19.6%), followed by bipolar disorder.
This work indicates that the rate of use of this therapy in hospitalized patients was only 0.71% over eight years. “This rate is relatively low when compared to other European countries. It is necessary to demystify some preconceptions, not only among the general population but also within the medical community”, says Pedro Mota, physician and another author of the study.
For Doctor Manuel Gonçalves-Pinho, a researcher and professor at FMUP, “there is a stigma and unjustified fear of this therapy motivated by ignorance about the technique used and outdated historical reports that the therapy would be painful and with significant adverse effects.
Electroshock treatment consists of alterations in the electrical activity in the brain and is performed under general anesthesia. It is currently indicated in antidepressant-resistant depression, schizophrenia, bipolar disorder, epilepsy, among other diseases. The procedure requires between six and 12 sessions to produce the desired therapeutic effect.
As part of the 1st.IndiQare project, this work had the participation of Manuel Gonçalves-Pinho (FMUP/CINTESIS/CHTS), Pedro Mota, João Pedro Ribeiro and Silvério Macedo (CHTS), Jorge Mota (Portuguese Society of ECT) and Alberto Freitas (FMUP/CINTESIS). The 1st.IndiQare is funded by FEDER – European Regional Development Fund, through COMPETE 2020 and the Portuguese Foundation for Science and Technology (FCT).