[Accessibility of electroconvulsive therapy during COVID-19 pandemic in Hungary].

Objectives: A nationwide survey in Hungary found that 22 out of 58 psychiatric units performed ECT in 2014. Shortly after identifying the first COVID cases, strict control measures were introduced, and the hospital system was fundamentally transformed in the country that affected ECT provision as well. The aim of the current study was to survey the changes in ECT use in Hungary during the four waves of the COVID-19 pandemic.

Methods: All the psychiatric units that indicated they had performed ECT in 2014 were sent a semi-structured question naire requesting information about changes in ECT practice and the treatment profile of the unit. If there was no reply, a follow-up telephone call was made.

Results: There were only 3 centers where ECT was performed throughout all four waves of COVID. In nine centers (47%) ECT was suspended in all four waves. The main reason why ECT was halted during COVID was the restructuring of psychiatric inpatient care: six centers were fully transformed into general COVID units, and in the remaining 13 the number of psychiatric beds was reduced in favor of general COVID care. Staff shortage constituted another barrier to the provision of ECT. The number of infected patients in a wave of COVID-19 showed a significant negative correlation with the number of active ECT centers (p=0.05). No COVID-infected patient received ECT in Hungary.

Conclusions: During the COVID pandemic in Hungary, nearly half of the ECT services were suspended and thus a number of patients missed out on receiving an effective treatment.