Electroconvulsive Therapy (ECT)
UVA is the major electroconvulsive therapy service in the central Virginia area. The number of patients served has tripled from 2004 to 2007 from 300-900 treatments annually. Patients have come for treatments from throughout the state (and even out of state), including as far as Lexington, Winchester, Harrisonburg, Fredericksburg, Williamsburg, and Virginia Beach. Some patients come to the University of Virginia for their ECT care even when other providers are available closer by, due to the reputation of our program, and with the absence of any advertising. The majority of treatments are provided on an outpatient basis, which requires additional services since (1) patients who receive ECT tend to have more severe psychiatric symptoms than other outpatients (2) These patients tend to be on several medications in addition to ECT (3) services must be coordinated with the patient’s local psychiatrist (4) patients must be continually monitored for safety and provided with education and advice not only for their psychiatric illness but from the potential physical and cognitive side-effects of ECT (e.g., monitoring for driving safety and ability to function in the community) and family members and/or friends typically also need to be involved in these discussions.
Psychiatry residents in the second and fourth year of training rotate through this service and receive supervision and didactics specific to the practice of ECT from the attending. Third and fourth year medical students may also participate. ECT competency is required for graduation.