2010) and 15 studies from this continent were included. ECT practice was verified
from 27 Asian countries: Bangladesh, China, Hong Kong, India, Indonesia, Iran, Iraq, Israel, Japan, Jordan, South Korea, Malaysia, Myanmar, Nepal, Oman, Pakistan, Philippines, Singapore, Sri Lanka, Thailand, Turkey, United Arab Emirates, Vietnam (Chanpattana et al. 2010), Fiji, Kiribati, Solomon Islands Inhibitors,research,lifescience,medical (Little 2003), and Saudi Arabia (Alhamad 1999). ECT was reported not available in all countries, such as Bhutan, Brunei, Cambodia, Georgia, Laos, and Lebanon (Chanpattana et al. 2010), Micronesia and Palau (Little 2003). The countries Cyprus, Macoa, Qatar, and Maldives had also been excluded by a survey (Chanpattana et al. 2010). Overall, the included studies displayed a large heterogeneity in the presentation of rate and prevalence data and practice of ECT worldwide. On a global basis, a crude estimate (from numbers given in Appendix C, Tables C1–C5) of worldwide contemporary TPR (SD) (age < 65 years) was 2.34 (1.56); Inhibitors,research,lifescience,medical EAR (SD), 11.2 (9.0); iP (SD) 6.1 (6.9); and AvE (SD) 8 (1.4). Globally, under half of all psychiatric institutions within the same country provided ECT. Main findings of ECT utilization, parameters, and practice from the five continents are presented below. ECT Utilization Treated
person rate Overview of TPR from all countries providing such data Inhibitors,research,lifescience,medical is buy PD184352 illustrated in Figure 2. Figure 2 Worldwide Treated Person Rates (TPR)—number of ECTs per 10,000 resident population per year. [Correction added after first online publication on 20 March 2012: The TPR column for UK (Department of Health 2007) has Inhibitors,research,lifescience,medical been changed to 1.84.] TPR (Fig. 2) varied from 0.75 in New Zealand (Ministry of Health 2005) to 4.4 in Victoria, Australia (Teh et al. 2005).
TPR in the USA Medicare population was 5.1 (5.7 women; 3.6 men) (Rosenbach et al. 1997). TPR by age groups (and therefore not included in Fig. 2) ranged from 0.0001 (<18 years) to 3.8 (>65 years) in California (Kramer 1999). TPR for the elderly (>65 years) in the Medicare population was from 2.4 to 4.2, (Rosenbach et al. 1997; Westphal et al. 1997) and varied from 3.8 West USA to 6.1 in the Inhibitors,research,lifescience,medical Northeast, as well as between rural (TPR 3.2) to large urban areas (TPR 6.0) (Rosenbach et al. 1997). TPR variations within the same State were reported from Louisiana, TPR (>65 years): 2.8 urban parishes versus 1.9 rural heptaminol parishes (Westphal et al. 1997). TPR in Europe varied between countries and regions and between individual centers (Fig. 2), with the lowest TPR 0.11 in Poland (Gazdag et al. 2009a). The within-country regional variation in Belgium (TPR 2.6–10.6) was reported as significant (Sienaert et al. 2006), which was also the case for Norway (TPR 1.83–3.44) (Schweder et al. 2011a). In South Africa, TPR was 1.26 (Mugisha and Ovuga 1991). In Asia, TPR was only reported from Thailand 1.15 (Chanpattana and Kramer 2004) and Hong Kong ranging 0.27–0.34 (Chung 2003; Chung et al. 2003; Chanpattana et al.