Preliminary Assessment of Pre-Electroconvulsive Therapy Evaluation Practices in European Countries The Need for Guidelines

S. Medved*, N. Zaja, G. Gazdag, A. Lengvenyte, S. Morkl, F. Mucci, I. Ristic, S. Jerotic, J.F. Regente, I. Ivanovic, A. Purisic, F. Sasvary, V. Sivasanker, A. Ziblak, M. Lookene, P. Sienaert, A. Szczegielniak, P. Trancik, E. Becirovic, T. KoutsomitrosG. Grech, C. Tapoi, B. Radmanovic, A. Strohle, M.B. Janovic, N. Sartorius

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objectives: Pre-electroconvulsive therapy (ECT) evaluation is an essential part of ECT preparation, a standard treatment in the psychiatric field. However, no routine pre-ECT evaluation has been published so far. This preliminary study aimed to explore different practices in pre-ECT evaluation across European countries.Methods: The data were collected as a snowball sample approach using an online survey from September 2019 to April 2020. The final analysis included data from 18 clinics placed in 16 European countries.Results: Regulations on the pre-ECT evaluation were found in 9 countries. All clinics reported doing complete blood count, serum electrolytes, and renal function analysis as a part of regular laboratory testing, alongside with a cardiovascular assessment. Ten clinics reported using psychiatric scales. Six clinics reported doing a cognitive assessment, of which all had regulations on the pre-ECT evaluation. Not one evaluation had the same sets of procedures and diagnostics.Conclusions: The differences in assessment approaches minor high variability of the pre-ECT evaluation practice across Europe. Cognitive assessment and objectification of psychiatric symptoms should be a regular part of the pre-ECT evaluation because of the monitoring of the most common adverse effect and observing the clinical response to ECT. Standardization of the pre-ECT evaluation and ECT in general would remove criticisms and opposition to the treatment, make it based on the best of our knowledge, and provide a method respectful of patients' best interests and rights.
Original languageEnglish
Pages (from-to)230-237
Number of pages8
JournalJournal of Ect
Issue number4
Publication statusPublished - 1 Dec 2022


  • electroconvulsive therapy
  • ECT
  • pre-ECT evaluation
  • psychiatric assessment
  • cognitive assessment


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