Work

Trends in electroconvulsive therapy use in France from 2017 to 2023: no decline despite new therapeutics

Year: 2025

Type: article

Abstract: • Significant increase for French ECT practice: standardized utilization rate raised from 0.33 patients per 10,000 inhabitants in 2017 to 0.50 in 2023. • French ECT use rate was 4 to 5 times below the international average. • COVID-19 event did not affect pre-pandemic trend, despite the significant drop in use rate during pandemic period. • ECT use increased particularly among younger and older populations, indicating a change in practice. • Uneven access to ECT services over the French territory, and the expansion of private care to the detriment of the public system, represent major public health issues. Objective Underutilization of electroconvulsive therapy (ECT) may have negative consequences for patients' mental health. Public healthcare policies lack longitudinal data on the dynamics of ECT use, which is necessary to inform the development of appropriate strategies. This study aimed to provide a comprehensive overview of ECT use in France over an extended period. Method We analyzed exhaustive ECT data from the French national database. We conducted statistical analyses of ECT utilization from 2017 to 2023, focusing on variations in age, sex, diagnosis, and geographical use. Results The French national standardized ECT utilization rate increased from 0.33 patients per 10,000 inhabitants in 2017 to 0.50 in 2023. The significant pre-pandemic trend, indicating a +1.4% increase in ECT use rate per month, remained unaffected by the pandemic, despite a significant drop during COVID-19 period. Notably, the increase in ECT use over this period was more pronounced among younger (≤29 years) and older (≥70 years) individuals. Two-thirds of ECT recipients were aged 50 years or older, predominantly female and had a mood disorder diagnosis. A key finding was that the increase in ECT use was mainly driven by the private-for-profit hospitals. ECT use and its evolution were geographically heterogeneous in France. Conclusion Despite the availability of new therapeutics and ongoing stigma, ECT use increased in France, particularly among younger and older populations, from 2017 to 2023, indicating a change in practice. However, uneven access to ECT services across the country and the expansion of private care to the detriment of the public system, represent a major public health concern that must be addressed.

Source: Psychiatry Research

DOI: 10.1016/j.psychres.2025.116738

Authors: D. Barruel, P. Belnou, M. Plaze, V. Dauriac-Le Masson

Institutions: Centre Hospitalier Sainte-Anne, GHU Paris psychiatrie & neurosciences

Language: English

Topic: Electroconvulsive Therapy Studies

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,230