Objective: To review and describe the practice of electroconvulsive therapy (ECT) in Belgium.
Methods: A 30-item questionnaire on the practice of ECT was sent to all institutions providing ECT.
Results: In 2003 ECT was offered in 32 hospitals. Although ECT hospitals are equally spread over three regions, there is a significant difference in the ECT utilization rate. There are no major regional differences in the practice of ECT. Fifty-three percent of the hospitals reported less than 10 treatment sessions per month. The major indication for ECT was depression (89.7%). Propofol was the anesthetic most commonly used (75%). Eleven departments (34.3%) used a sine wave device. Bitemporal electrode placement was the preferred option in 65.6% of all departments, and 37% of these used the combination of bitemporal electrode placement and a fixed high stimulus dose. Continuation ECT and outpatient ECT were rarely used.
Limitations: This questionnaire study relies upon answers given by psychiatrists, and did not audit actual practices.
Conclusions: Although ECT is widely available in Belgium, it remains underused and the practice of ECT is amenable for improvement. Guidelines should be implemented and continuing education is needed.