April 26, 2022 (Toronto) – Electroconvulsive therapy (ECT) was associated with a 50 per cent reduction in risk for suicide among patients with depression in the year after their hospitalizations, according to a new CAMH- and ICES-led study of over 67,000 patients published in the journal Lancet Psychiatry.
It is the most convincing study to date that establishes a clear link between ECT and suicide prevention, and builds on a previous CAMH study using ICES patient data published in Lancet Psychiatry in July 2021 that established that ECT has a very safe medical side effect profile.
“ECT significantly reduced the risk of suicide death while also being a medically safe procedure,” said lead author Dr. Tyler Kaster, Medical Head of the Temerty Centre for Therapeutic Brain Intervention at CAMH. “These findings suggest that ECT can prevent suicide in severe depression and potentially be a life-saving procedure.”
Researchers have been challenged with finding answers to the important question of how to measure the impact of ECT on suicide prevention, since to study this in a clinical trial would be next to impossible. Suicide is an extremely rare event, so tens of thousands of patients would need to be enrolled in such a trial. This study used ten years of Ontario patient hospitalization data housed at ICES, including the Ontario Mental Health Reporting System that provides an unprecedented level of detail regarding the social, demographic and clinical characteristics of patients hospitalized for mental health problems in Ontario. These datasets enabled the researchers to identify patients with depression who received ECT as well as patients with very similar characteristics who did not receive ECT – and then look forward to compare the two groups on their risk for suicide in the year after hospitalization.
Among the 67,000 patients hospitalized for depression during the ten-year study period, just under 9 per cent received ECT while the other 91 per cent did not. According to the authors, the reasons patients do not receive ECT is fear about the procedure, lack of access to treatment, or ECT not being presented as an option by the clinical team.