did ect use in quebec fall by a third over 15 years?
“I looked at 15 years worth of data finding that ECT treatment in Quebec has dropped by about a third, 33% less ECT over the 15-year period.”
a guest, a psychiatrist said on PsychEd: Educational Psychiatry Podcast, 2026-11-01, at 51:57. hear it in context → the speaker cited: a Canadian Journal of Psychiatry study of Quebec data.
the episode: PsychEd Case Rounds 1 with Dr. David Gratzer (at 51:57). we link the show's own page; we do not re-host audio.
first, the part that holds
The number is right and so is the source. A Canadian Journal of Psychiatry study of linked Quebec health administrative data found the age-standardized rate of people receiving ECT fell from 15 to 10 per 100,000, which the authors call a 33% decrease. They describe it as "a downward trend... in the 15 y of the study."
what we found when we went and looked
We read the study in full on PubMed Central. It tracked everyone in Quebec who received ECT from April 1996 to March 2013, 8,149 people in all, using five linked provincial health databases. The age-standardized annual prevalence fell from 15 per 100,000 in 1997–2002 to 10 per 100,000 in 2008–2013, a 33% decrease. That works out to about −3.4% a year (95% CI −4.0 to −2.8), and the drop was steeper in women and in older people. Two details matter for anyone repeating the figure. The 33% compares two six-year averages and counts people treated, not individual ECT sessions. And the data stop in 2013, so the figure says nothing about Quebec today.
assertion by assertion
| assertion | verdict | what the record says |
|---|---|---|
| ECT use in Quebec fell by about a third (33%) over the study period | confirmed | Age-standardized annual prevalence of people treated with ECT fell from 15 per 100,000 (1997–2002) to 10 per 100,000 (2008–2013), which the authors call a 33% decrease. The annual change was −3.4% (95% CI −4.0 to −2.8). This compares two six-year windows and counts persons treated, not sessions. [1] |
| the period covered was about 15 years | confirmed | The data run from April 1996 to March 2013, and the authors themselves write 'a downward trend was observed in the 15 y of the study'. The midpoints of the two windows being compared are about 11 years apart. [1] |
| the finding comes from a Canadian Journal of Psychiatry study of Quebec data | confirmed | Published in the Canadian Journal of Psychiatry (2017, print 2018), doi:10.1177/0706743717738492. It used linked Quebec health administrative databases (physician claims plus hospitalization files). [1] |
| the decline was uniform across Quebec (a reading listeners might take away) | overstated | The study reports declines in every age group and in both sexes: −4.0% a year in women and −2.3% in men. But two regions moved the other way, rising 35% and 62%, and the authors stress marked regional variation. [1] |
| ECT use is falling in Canada generally (a common extrapolation) | misattributed | A later Canadian Journal of Psychiatry study of Ontario found ECT procedures per 1,000 adults rose from 1.69 in 2007 to a peak of 3.08 in 2019, then fell to 2.54 in 2023. Its authors explicitly contrast this with the Quebec decline. The two studies use different measures (procedures per 1,000 adults versus persons per 100,000), so the figures can't be compared directly. Still, the Quebec trend can't be generalized to Canada. [2] |
both directions
for the speaker: The study is exactly where the speaker said it was, and the 33% figure appears in it word for word. It is a whole-population study, not a sample. It linked physician billing and hospital discharge records across the province, and the trend has a tight confidence interval (−3.4% a year, 95% CI −4.0 to −2.8). The authors use the same "15 years" framing the speaker used. The decline showed up in both sexes and in every age group.
against: The claim is accurate, but heard on its own it can imply more than the paper supports. The 33% compares two six-year averages (1997–2002 against 2008–2013) of people treated per year. It is not a count of ECT sessions, so it doesn't say whether people who did receive ECT got more or fewer treatments. The data end in March 2013, more than a decade before the episode aired. Two Quebec regions saw large increases (35% and 62%). In neighboring Ontario, a later study in the same journal found ECT procedures per adult rose substantially from 2007 to 2019, so "ECT is declining" doesn't hold as a statement about Canada. The authors offer possible reasons for the decline, such as wider use of medication alternatives, hospital mergers and a 2002 provincial health-technology report. They frame these as assumptions, not findings.
what this cannot say
The data come from administrative records. They miss ECT given by general practitioners and by physicians not paid fee-for-service, which the authors note could lead to some undercounting. They hold nothing on ECT technique, outcomes or side effects, so the study can't say whether the decline was good or bad for patients. We read the full text on PubMed Central. The publisher's page blocked automated access, so we didn't check the PMC version against it line by line. We found no peer-reviewed Quebec figures after 2013 on our allowed sources, so we can't say whether the trend continued.
sources, each one fetched and read
- Electroconvulsive Therapy Practice in the Province of Quebec: Linked Health Administrative Data Study from 1996 to 2013. Canadian Journal of Psychiatry, 2017 (print 2018). doi:10.1177/0706743717738492 What we read there: "A downward trend was observed in the 15 y of the study, with age-standardised rates decreasing from 15 per 100,000 for 1997 to 2002 to 10 per 100,000 for 2008 to 2013 (33% decrease)"; annual decrease −3.4% (95% CI −4.0 to −2.8); 8,149 persons treated 1996–2013; annual prevalence 13 per 100,000; two regions increased by 35% and 62%. Fetched 2026-11-01 (HTTP 200). https://pmc.ncbi.nlm.nih.gov/articles/PMC6099779
- Electroconvulsive Therapy Variability Across Ontario 2007–2023: A Population Level Study. Canadian Journal of Psychiatry, 2025;71(1):53–63. doi:10.1177/07067437251371977 What we read there: 450,381 ECT procedures; the yearly rate rose from 1.69 per 1,000 adults in 2007 to 3.08 in 2019, then fell to 2.54 in 2023. "In contrast to the only prior study of Canadian based volumes from the province of Quebec, which found a general decrease in the rate of ECT... our study found a significant increase." Fetched 2026-11-01 (HTTP 200). https://pmc.ncbi.nlm.nih.gov/articles/PMC12394196/
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