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EV1273

Is the Use of Inpatient Electroconvulsive Therapy Declining in Slovakia? A National Analysis of Trends from 2019 to 2024

IS INPATIENT ELECTROCONVULSIVE THERAPY USE DECLINING IN SLOVAKIA? A NATIONAL ANALYSIS OF TRENDS FROM 2019 TO 2024

Hospitalizations with recorded ECT in Slovakia fell from 1,507 in 2019 to 1,121 in 2024 (a 25.6% decrease), while their share of all psychiatric hospitalizations declined from 3.62% to 2.88%.

The study aimed to examine national trends in inpatient electroconvulsive therapy (ECT) use following a 2008 national survey reporting that ECT was available in 33 of Slovakia's 36 psychiatric departments. Annual national aggregate data from NCZI on completed psychiatric hospitalizations between 2019 and 2024 were analyzed, with a hospitalization ending in discharge, transfer, or death serving as the unit of analysis. The proportion of hospitalizations with recorded ECT was calculated both overall and within the ICD-10 F30–F39 diagnostic group, and annual and period comparisons were descriptive. The numbers of hospitalizations with recorded ECT were 1,507 (2019), 1,334 (2020), 1,201 (2021), 1,489 (2022), 1,043 (2023), and 1,121 (2024), representing a 25.6% decrease between 2019 and 2024. Across all psychiatric diagnoses, the proportions with recorded ECT were 3.6%, 3.8%, 3.4%, 4.0%, 2.8%, and 2.9%, respectively; for mood (affective) disorders (F30–F39), they were 6.8%, 8.4%, 7.8%, 8.5%, 5.9%, and 6.4%. The overall proportion declined from 3.62% to 2.88%, a decrease of 0.74 percentage points. Thus, despite a slight increase in 2024, recorded ECT use in 2023–2024 was lower than in 2019–2022, both overall and for mood disorders. A national ECT standard came into effect on April 1, 2020, but the study did not assess the effects of this standard or other contextual events. As limitations, the author notes that aggregate records do not identify unique patients, the number of ECT sessions, or outpatient care; repeated hospitalizations may involve the same individual; changes in coding or case mix may have contributed; and service capacity, access, outcomes, and causal mechanisms were not assessed. In conclusion, the study emphasizes the need for further research, as the reasons for the decline and its clinical impact remain unclear.

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