To determine the characteristics of electroconvulsive therapy (ECT) practice in Australia.

From October 1, 2002 to February 29, 2004, a 29-item questionnaire was sent to 136 hospitals in Australia.

113 hospitals (83%) completed the questionnaire. ECT was available in 90 hospitals. A total of 7,469 patients received 58,499 ECTs from 356 psychiatrists, which gives an average course length of 8.5 treatments. ECT utilization as assessed by the crude treated-person and crude administration rates were 37.85 persons and 296.47 administrations per 100,000 population per annum, respectively. 63.4% of patients were female. Brief-pulse devices were used in all hospitals. EEG monitoring was used routinely in 80 hospitals. Unilateral ECT was used twice as often as bilateral ECT. 82.3% of ECT treatments were given to patients with major depression, 9.6% with schizophrenia, 4.9% with mania, and 1.7% with catatonia. Patients who received ECT were in age group over 65 years (38.4%), followed by 45-64 years (28.3%), 25-44 years (26.3%), 18-24 years (6.9%), and less than 18 years (0.2%). Unmodified ECT was not used in any hospital. 1,196 patients received continuation ECT in 83 hospitals and 1,044 received maintenance ECT in 77. There was no case of ECT-related death during a survey period.

ECT use in Australia is high. ECT training programs for psychiatry residents were acceptable. The pattern of use is similar to that of the United States.