Patients' Experiences of and Attitudes to Electroconvulsive Therapy (original) (raw)
Related papers
World Journal of Biological Psychiatry 2010; 11: 525–537., 2010
Objectives. Despite its proven effi cacy and safety, electroconvulsive therapy (ECT) has a negative image and attracts widespread public criticism. In contrast, perceptions of patients who have received ECT appear to be more favourable. This review intended to encapsulate the evidence on knowledge and views concerning ECT among its recipients. Methods. Extensive electronic and manual searches were conducted to identify all relevant studies on the subject. Results. Seventyfi ve reports were found suitable. The evidence from these studies suggested that patients undergoing ECT were usually poorly informed about it. This was attributable to factors such as unsatisfactory pre-treatment explanations or post-ECT memory impairment. About one-third undergoing ECT reported feeling coerced to have the treatment. Fear of ECT and distressing side effects were also present in a majority. Despite these problems, a vast majority of patients perceived ECT to be helpful and had positive views regarding the treatment. Simultaneously, a sizeable proportion was quite critical, although little was known about the extent and nature of such disapproval. Conclusions. Overall, the weight of the evidence supports the notion that patients undergoing ECT are well-disposed towards it. However, much needs to be done to improve the practice of ECT and to enhance patients’ satisfaction with the experience of treatment.
Electroconvulsive Therapy: Part II: A Biopsychosocial Perspective
Journal of Psychiatric Practice, 2009
The myths surrounding electroconvulsive therapy (ECT) and the misconceptions held by the general public, clinicians, and patients have interfered with acceptance of this treatment throughout its history. Misunderstandings surrounding ECT, and its consequent stigmatization, are reviewed, including negative depictions of ECT in film, print media, and on the Internet. Clinicians involved in the delivery of ECT benefit from gaining an understanding of how ECT may be perceived by patients and other mental health professionals; they can play a vital role in educating patients and helping ensure the delivery of a successful course of ECT. Guidance is provided for clinicians on how to support patients and families through the ECT process using a model team approach. Anxiety reduction, meeting individual needs, patient and family psychoeducation, assessment of psychosocial supports, and discharge planning are discussed.
Patients’ Perspectives on Electroconvulsive Therapy
The Journal of ECT, 2012
In 2003, based on a review of 7 studies, Rose et al concluded that at least one third of patients report significant memory loss 6 months or more after electroconvulsive therapy (ECT). However, few details on the included studies were given. The present study evaluates factors that may have influenced the results. Methods: The 7 studies were scrutinized as to the 6-month assessment criterion, whether the data represent ECT-treated patients in general, specification and significance of the memory loss, stimulus type, and electrode placement. Results: In 3 studies, the 6-month inclusion criterion was not met, including 1 study with 98% satisfied patients and 1 study with only 37% valid response rate. Two other studies selected individuals from user/advocacy groups generally biased against ECT and were probably overlapping. The significance of memory problems was not mentioned in any of the studies. Two studies reported that 30% and 55% of patients treated with bilateral ECT in the 1970s felt they had persistent memory gaps around the time of treatment, but the long-obsolete sine wave stimulus type was used. The results mostly concerned bilateral ECT, whereas unilateral ECT seemed to cause little complaints. Conclusions: Data used by Rose et al are severely flawed, making their results inconclusive and misleading.
Efficacy of electroconvulsive therapy: Too Brief Or Not Too Brief?: Too Brief Or Not Too Brief?
2015
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2006
To compare the efficacy of ECT with those of pharmacological treatment modalities, and to bring to light the continuing usefulness of ECT despite the availability of a number of newer and better medicines. Design: A prospective comparative study. Setting: Department of psychiatry, Combined Military Hospital Pano Aqil Cantt Period From Jan 2003 to March 2004. Subjects and Methods: Patients suffering from Major Depression, Mania, Puerperal Psychosis, and Schizophrenia, were included in the study. Two groups were made. I.e. patients treated with medicines only (group I), and patients treated with ECT alone as first line therapy(Group II). Each group comprised 50 patients. Patients belong to two groups were matched closely regarding their age, sex duration or illness, clinical picture and previous treatment etc. Response to treatment was judged with the help of HDRS in case of depressed patients and clinically only in rest of the patients. Results of the treatment were recorded and comparison made for two groups. SPSS was utilized to obtain statistical significance. Results: ECT proved to be a superior treatment in the achievement of quick remission, especially in those depressed patients with acute onset, psychomotor retardation, psychotic features, and severe disabling anxiety associated with primary illness. Very excited manic patients quickly responded to ECT and calmed down. Catatonic Schizophrenics showed dramatic response, and so did patients with puerperal Psychosis, in achieving early remission. Conclusion: In-spite of misinformation by media, and misconceptions in the minds of lay people, as well as, those related to medical profession, ECT remains a very effective and safe treatment even today. It should be used without hesitation wherever indicated. Limitations of present study need improvement in future studies, in order to achieve more scientifically oriented results.
Contemporary use and practice of electroconvulsive therapy worldwide
Brain and Behavior, 2012
To explore contemporary (from 1990) utilization and practice of electroconvulsive therapy (ECT) worldwide. Systematic search (limited to studies published 1990 and after) was undertaken in the databases Medline, Embase, PsycINFO, SveMed, and EBSCO/Cinahl. Primary data-based studies/surveys with reported ECT utilization and practice in psychiatric institutions internationally, nationally, and regionally; city were included. Two reviewers independently checked study titles and abstracts according to inclusion criteria, and extracted ECT utilization and practice data from those retrieved in full text. Seventy studies were included, seven from Australia and New Zealand, three Africa, 12 North and Latin America, 33 Europe, and 15 Asia. Worldwide ECT differences and trends were evident, average number ECTs administered per patient were eight; unmodified (without anesthesia) was used in Asia (over 90%), Africa, Latin America, Russia, Turkey, Spain. Worldwide preferred electrode placement was bilateral, except unilateral at some places (Europe and Australia/New Zealand). Although mainstream was brief-pulse wave, sine-wave devices were still used. Majority ECT treated were older women with depression in Western countries, versus younger men with schizophrenia in Asian countries. ECT under involuntary conditions (admissions), use of ambulatory-ECT, acute first line of treatment, as well as administered by other professions (geriatricians, nurses) were noted by some sites. General trends were only some institutions within the same country providing ECT, training inadequate, and guidelines not followed. Mandatory reporting and overall country ECT register data were sparse. Many patients are still treated with unmodified ECT today. Large global variation in ECT utilization, administration, and practice advocates a need for worldwide sharing of knowledge about ECT, reflection, and learning from each other's experiences.
Patient Satisfaction With Electroconvulsive Therapy
Mayo Clinic Proceedings, 1999
Objective: To determine whether patients who have electroconvulsive therapy (ECT) are satisfied with their treatment and demonstrate more favorable attitudes about ECT compared with controls.
The Dilemma of Unmodified Electroconvulsive Therapy: (Commentary)
The Journal of Clinical Psychiatry, 2003
It's a small, small world." Although it has been many years since I first heard that Disney staple, never before has it been as true as in the current era of rapid transportation and instant communication. On a lecture tour last year to India with Max Fink, M.D., I became aware of an Indian Supreme Court case involving electroconvulsive therapy (ECT). Unequaled in efficacy for the treatment of severe and psychotic depression, catatonia, and other psychotic disorders, ECT remains mired in controversy throughout the world. The following commentary by Dr. Chittaranjan Andrade and coauthors is thoughtful and illuminating. East meets West.-A.J.G.
Some Reflections About Electroconvulsive Therapy ( Ect )
2020
Long-standing psychiatric practice confirms the pervasive use of pharmacological therapies for treating severe mental disorders. In many circumstances, drugs constitute the best allies of psychotherapeutic interventions. A robust scientific literature is oriented on finding the best strategies to improve therapeutic efficacy through different modes and timing of combined interventions. Nevertheless, we are far from triumphal therapeutic success. Despite the advances made by neuropsychiatry, this medical discipline remains lacking in terms of diagnostic and prognostic capabilities when compared to other branches of medicine. An ethical principle remains as the guidance of therapeutic interventions: improving the quality of life for patients. Unfortunately, psychotropic drugs and psychotherapies do not always result in an efficient remission of symptoms. In this paper I corroborate the idea that therapists should provide drugresistant patients with every effective and available treatm...