The Use of Electroconvulsive Therapy and the Length of Stay of Psychiatric Inpatients at King Chulalongkorn Memorial Hospital, Thai Red Cross Society
Decha Lalitanatpong MD*
Affiliation : * Department of Psychiatry, Faculty of Medicine, Chulalongkorn University
Background : Electroconvulsive therapy ( ECT ) is the effective treatment in psychiatric patients. However, the
controversies about the risk and benefit limit the use of this procedure. Some efficacies of ECT may be interest-
ing to use in hospitalized patients such as rapid onset, risk reduction but it may increase the length of stay
(LOS ) in previous study.
Objectives : To study the use of ECT in hospitalized psychiatric patients in the aspect of indication , diagnosis
and the length of stay.
Materials and Methods : From August to September 2004 , all 51 cases of psychiatric inpatient medical records
were studied . The top five of diagnosis were schizophrenia (49%) , bipolar disorder (23.5%), acute psychosis
(7.8% ),depressive disorder (5.9%) and dementia (5.9%). ECT was performed in 22 cases (43.1%).
Results : The average length of stay was 21.5 ±14.5 days . The mean LOS of the ECT group 25.9±15.8 days was
not quite longer compared with 17.8 ±12.7 days of the Non ECT group comparison between the ECT group
(64 %) and the non ECT group (36 %) of schizophrenia , the LOS of each group was 27.3±16.7and 16.9±8.8
days which was also not significant . LOS of ECT of the bipolar group (20%) and the non ECT bipolar group
(80%) was 10.5±4.9 and 23.0±18.3 days which was not statistically significant (p=0.39). There were 3 major
indications for ECT such as a severe violence case, suicidal case, refractory case with the mean LOS of
19.9±10.9, 17.5±12.8, 43.3±21.2 and 31.7±8.3 days subsequently. The patients who had the refractory indica-
tion had a longer length of stay than other indications.
Conclusion : Overall average length of stay was not longer in the ECT group . The ECT group had a longer
length of stay than the non ECT group in the refractory treatment case only . ECT can be used in a psychiatric
ward with the efficacy of its indication without prolonged length of stay .
Keywords : Electroconvulsive therapy (ECT), Length of stay (LOS), Psychiatry, Diagnois, Inpatient, Thai
