Involuntary and voluntary electroconvulsive therapy: A case-control study

It is not known whether results of clinical research in ECT can be used to guide treatment decisions for those having involuntary ECT, who are not represented in trial populations. We aimed to compare courses of involuntary ECT with matched voluntary ECT courses in terms of clinical and demographic factors, treatment requirements, and outcomes. We performed a retrospective case-control study examining a five-year sample of involuntary ECT courses and an age-, gender- and time-matched voluntary ECT control sample. We examined 48 involuntary and 96 control voluntary ECT courses. While groups differed at baseline in terms of diagnosis, illness severity and illness characteristics, there were no differences in treatment outcomes after ECT or six-month readmission rates. Our findings suggest that research on capacitous ECT patients is applicable to those having involuntary ECT. •Largest reported cohort of involuntary ECT courses examined to date.•48 involuntary ECT courses compared to 96 matched voluntary courses.•Groups differed in terms of diagnosis, illness severity and characteristics.•No differences in treatment outcomes or six-month readmission rates.