ECT in Dutch practice
In the Netherlands ECT is hardly used. Compared to countries such as USA, UK and Denmark, ECT is used 100 to 200 times less frequently per inhabitant. During the years 1981-1984 the Psychiatric Centre Bloemendaal served as a kind of regional centre for ECT for two Dutch provinces with a total population of 5.5 million inhabitants. During these years 35 non-geriatric patients were treated with a total of 38 courses of ECT. The indication in most cases (31 patients) was a severe, therapy-resistant major depression according to DSM-III. The mean duration of their current episodes was about two years. ECT was effective in 53% . A retrospective study, using medical-, nurse- and research files, to clinical parameters, revealed that ECT was significantly more effective in the subgroup of patients with a major depression with melancholia than in the non-melancholic group (p = 0.002), but not more effective in the subgroup with psychotic features than in the non-psychotic group. Furthermore a significant negative correlation (r = —0.36, p = 0.02) was found with the duration of the episode, indicating that ECT is less effective in longer-lasting depressions.