{ "abstract": "Background: Electroconvulsive therapy (ECT) is a safe and effective medical treatment, yet provision varies internationally. We provide an up-to-date review of ECT practice in Nordic and western European countries.\n\nMethods: European experts contributed data from peer-reviewed literature, governmental publications, unpublished administrative datasets, and hitherto unpublished surveys. The primary outcome was the number of individuals treated with ECT in each country per year. Primary analysis compared the annual treated person rate per million population in the most recent year since 2015 for which data were available. Secondary analysis compared trends in rates over 25 years, in countries for which a reliable outcome was available at two or more time points.\n\nResults: Across 15 countries, 12 had data meeting primary analysis criteria. Of these, all Nordic countries had annual treated patient rates per million population over 200, Italy 2.7, and other western European countries between 30 and 100. German-, Dutch-, and French-speaking countries saw increases in ECT use over 25 years, while English-speaking countries exhibited declines. Unilateral placement varied from 16% of treatments in the United Kingdom to 79% in Norway. Everywhere, most ECT was given for depressive episodes.\n\nConclusions: Although the optimal rate of use is unknown, widely differing rates across European nations suggest ECT is underused in some high-income countries, depriving patients of vital medical care. The European ECT community must support the development of reliable data collection on usage across the continent and service improvement where provision is underdeveloped, to ensure appropriate treatment is offered to all patients for whom it is indicated.", "abstract_shown": true, "affiliations": [ "Department of Clinical Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, UK", "Meadowfield Hospital, Sussex Partnership NHS Foundation Trust, Worthing, UK", "Inserm, CHU Lille, U1172, LilNCog, Lille Neuroscience & Cognition, University of Lille, Lille, France", "Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK", "Department of Mental Health, ASL Biella, Biella, Italy", "Department of Adult Psychiatry, Rankweil Regional Hospital, Rankweil, Austria", "Department of Psychiatry, Trinity College Dublin, Dublin, Ireland", "Department of Psychiatry, Tallaght University Hospital, Dublin, Ireland", "Departamento de Saúde Mental, Unidade Local de Saúde do Baixo Alentejo, Beja, Portugal", "Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal", "Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal", "Department of Psychiatry and Mental Health, Unidade Local de Saúde Tâmega e Sousa, Penafiel, Portugal", "Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany", "Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland", "Department of Psychiatry, Tampere University Hospital, Tampere, Finland", "Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark", "Psychiatric Centre Copenhagen, Frederiksberg, Denmark", "Department of Psychiatry, Oulu University Hospital, Wellbeing Services County of Northern Ostrobothnia, Finland", "Research Unit of Population Health, University of Oulu, Oulu, Finland", "Department of Clinical Medicine, University of Bergen, Bergen, Norway", "Division of Psychiatry, Haukeland University Hospital, Bergen, Norway", "Centre for Social and Affective Neuroscience, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden", "Department of Psychiatry, Region Östergötland, Linköping, Sweden", "University Psychiatric Center KU Leuven, Academic Center for ECT and Neuromodulation (AcCENT), Kortenberg, Belgium", "Champalimaud Clinical Centre, Neuroscience of Disease Programme & Digital Neurotherapeutics Centre, Champalimaud Foundation, Lisbon, Portugal", "Nova Medical School (NMS), Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Lisbon, Portugal", "Mental Health Care Institute, GGz Centraal, Amersfoort, Netherlands", "Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands", "Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands", "Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands", "Institute for the History of Medicine, Carl Gustav Carus Faculty of Medicine, Dresden University of Technology, Dresden, Germany", "Division of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK" ], "article_type": "research article", "arxiv": null, "author_total": 20, "authors": [ { "affs": [ 0, 1 ], "name": "Richard Braithwaite", "orcid": "0000-0002-7863-4906" }, { "affs": [ 2, 3 ], "name": "Ali Amad", "orcid": "0000-0002-9029-2910" }, { "affs": [ 4 ], "name": "Carlo Ignazio Cattaneo", "orcid": "0000-0002-6930-8105" }, { "affs": [ 5 ], "name": "Jan Di Pauli", "orcid": "0009-0002-4918-2215" }, { "affs": [ 6, 7 ], "name": "Martha Finnegan", "orcid": "0000-0002-3727-3497" }, { "affs": [ 8, 9 ], "name": "Pedro Frias", "orcid": "0000-0002-0023-2341" }, { "affs": [ 10, 11 ], "name": "Manuel Gonçalves-Pinho", "orcid": "0000-0001-6098-429X" }, { "affs": [ 12 ], "name": "Michael Grözinger", "orcid": "0000-0001-8700-9646" }, { "affs": [ 13, 14 ], "name": "Kaija Järventausta", "orcid": "0000-0001-5906-1367" }, { "affs": [ 15, 16 ], "name": "Anders Jørgensen", "orcid": "0000-0001-6012-6965" }, { "affs": [ 17, 18 ], "name": "Saana Karttunen", "orcid": "0009-0002-4837-256X" }, { "affs": [ 19, 20 ], "name": "Ute Kessler", "orcid": "0000-0002-2002-5518" }, { "affs": [ 21, 22 ], "name": "Pia Nordanskog", "orcid": "0000-0001-8805-8095" }, { "affs": [ 23 ], "name": "Jasmien Obbels", "orcid": "0000-0001-6351-1543" }, { "affs": [ 24, 25 ], "name": "Albino J. Oliveira-Maia", "orcid": "0000-0001-5071-3007" }, { "affs": [ 26, 27 ], "name": "Didi Rhebergen" }, { "affs": [ 23 ], "name": "Pascal Sienaert", "orcid": "0000-0002-0650-415X" }, { "affs": [ 26, 28, 29 ], "name": "Floris Quirijn Tas", "orcid": "0000-0003-1850-9051" }, { "affs": [ 30 ], "name": "Saskia Wilhelmy", "orcid": "0000-0001-6650-8630" }, { "affs": [ 31 ], "name": "George Kirov", "orcid": "0000-0002-3427-3950" } ], "bibtex": "https://research.draconitic.com/paper/3djv67szvcqqt.bib", "cited_by": 0, "doi": "10.1192/j.eurpsy.2026.12238", "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13735846/", "id": "3djv67szvcqqt", "issns": [ "0924-9338", "1778-3585" ], "landing_url": "https://doi.org/10.1192/j.eurpsy.2026.12238", "language": "en", "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Research Article" ], [ "openalex", "2738|Electroconvulsive Therapy Studies" ] ], "openalex": "W7171617074", "pdf_url": "https://www.cambridge.org/core/services/aop-cambridge-core/content/view/5CBE2E1EEEF536166E4285ABB7B0F7D8/S092493382612238Xa.pdf/div-class-title-use-of-electroconvulsive-therapy-in-nordic-and-western-european-countries-div.pdf", "pmcid": "PMC13735846", "pmid": "42522846", "published": "2026-07-29", "publisher": "Cambridge University Press", "ris": "https://research.draconitic.com/paper/3djv67szvcqqt.ris", "sources": [ { "first_seen": "2026-11-09T12:21:26Z", "native_id": "PMC13735846", "source": "pmc", "url": "https://doi.org/10.1192/j.eurpsy.2026.12238" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2738|Electroconvulsive Therapy Studies", "subfield": "psychiatry" } ], "title": "Use of electroconvulsive therapy in Nordic and western European countries", "title_text": "Use of electroconvulsive therapy in Nordic and western European countries", "type": "peer-reviewed", "updated_at": "2026-11-09T12:21:26Z", "url": "https://research.draconitic.com/paper/3djv67szvcqqt", "venue": "European Psychiatry", "versions": [] }