Fig. 1: Frequencies of lithium and ECT usage, their deviation from the median, and correlation across Swedish regional councils (2016–2020). | npj Mental Health Research

Fig. 1: Frequencies of lithium and ECT usage, their deviation from the median, and correlation across Swedish regional councils (2016–2020).

From: Youth with severe mental illness and complex non-somatic motor abnormalities: conflicting conceptualizations and unequal treatment

Fig. 1

Openly available data from the Swedish National Board of Health and Welfare was analyzed to evaluate the frequency of lithium and ECT usage in adolescents for the period 2016–2020, separated by the regional council. For lithium treatment, the number of patients aged 0–17 years and receiving lithium treatment per 1000 inhabitants was extracted for each respective region. Similarly, the number of patients aged 13–17 years and receiving ECT treatment per 1000 inhabitants was extracted from the Swedish ECT registry for each respective region. The figure depicts the usage frequency of lithium and ECT over the national median. University-affiliated counties are highlighted in red, others in blue. County population, retrieved from the Swedish Central Bureau of Statistics, is illustrated by circle diameter. Correlations between ECT and lithium frequencies were assessed by robust linear regression models and the regression slope is illustrated by the dashed line. For a detailed description pertaining to the methods underlying Fig. 1, please see Supplementary Information. Figure 1 demonstrates that (1) Five regions in Sweden—caring for 65 736 adolescents and ~11% of Sweden’s population aged 13–1759—did not utilize ECT treatment at all in the care of adolescents over a 5-year-period. (2) There were large variations in frequencies of advanced treatment usage between regions compared to the national average: 0–6.7× for Lithium and 0–11.1× for ECT. (3) Frequencies of ECT and lithium usage were significantly positively correlated across regions (r = 0.75, p < 0.05). (4) There were no significant associations between university-affiliated major regions when compared to other regions in terms of frequencies of ECT (p > 0.05) or lithium (p > 0.05) usages. (5) Lastly, counties affiliated with major cities and university research clinics were not among the five counties with the highest frequencies of ECT treatment usage.

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