Retrospective Cohort Study of Racial-Ethnic Disparities in Receipt of Electroconvulsive Therapy, 2016-2021

Division

TriStar

Hospital

TriStar Centennial Medical Center

Document Type

Manuscript

Publication Date

5-14-2025

Keywords

ECT, depression, electroconvulsive therapy, electroshock therapy, racial-ethnic disparities, trends

Disciplines

Medicine and Health Sciences | Mental Disorders | Psychiatry | Psychiatry and Psychology | Therapeutics

Abstract

OBJECTIVE: Electroconvulsive therapy (ECT) is an effective treatment for severe depression, but racial-ethnic disparities in its receipt have long been observed, and previous studies have had limited generalizability. This study aimed to determine whether racial-ethnic disparities persist in contemporary treatment environments after adjustment for various demographic factors.

METHODS: A retrospective study was conducted among patients with data in the HCA Healthcare Enterprise Data Warehouse who were diagnosed as having severe unipolar depression (

RESULTS: Analyses were conducted for 19,011 unique patients. Significant variation by race-ethnicity was found for all covariates (p< 0.001). ECT was administered to 3% of White patients and 1% of non-White patients. Compared with all other race-ethnicities, the unadjusted odds ratio for ECT receipt among White patients was 3.12 (p< 0.001). Patients from each non-White racial-ethnic group had significantly lower rates of ECT receipt compared with White patients, including Asian (adjusted OR [aOR]=0.43, p< 0.001), Black (aOR=0.27, p< 0.001), and Hispanic (aOR=0.39, p< 0.001) patients and patients identifying as other race-ethnicity (aOR=0.53, p=0.001).

CONCLUSIONS: In this nationwide study, significant disparities in ECT use, by self-identified racial-ethnic identity, were observed even after demographic covariates were controlled.

Publisher or Conference

Psychiatric Services

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