This website aims to represent the science, the sociology and the emotion of electroconvulsive therapy fairly and in a way that can be easily understood
Search Results for: electroconvulsive therapy
Electroshock or Electro convulsive therapy is often depicted negatively in Hollywood films. It encourages stigmatization and discourages patients from its use. So if your About To Have ECT? Fine, but Don’t Watch It in the Movies: The Sorry Portrayal of ECT in Film. You can read more about electroshock in Hollywood productions in this prior post on this blog.
If you want some information on video from patients while they are actually undergoing this treatment or want to see an excellent lecture about ECT please have a look at: 9 Videos on ECT.
In newspapers when comparing newspaper reports on ECT and electric defibrillation with a content analysis the articles with mentioning ECT differ from articles with a mention of defribillation.
Even in high standard newspapers the style of language becomes special when they deal with ECT.The articles are strongly biased and lack informations. In contrast to Defibrillation ECT is not generally accepted.Referring to ECT horror pictures of past psychiatry are cited.The language used is biased and discriminative. Referring to Defibrillation technical details are described and the language is neutral.The social representation of ECT is completely negative.
The content analysis was performed on articles in German Newspapers. They traced only few special articles on the subject in the 1994 and 1995 CD.Rom versions of the „Der Spiegel“,The „Frankfurter Allgemeine Zeitung“, the „Neue Zürcher Zeitung“ and the „Berliner Tageszeitung“,although the word „Elektroschock“ was employed 118 times. The word electroshock was mostly used in articles not about ECT. The term was mostly used because of it’s negative connotation in all kinds of subjects.
Why is this important?
The portrayal of ECT is deplorable and with little resemblance to modern practice. It encourages stigmatization and discourages patients from its use. Proponents of ECT will need to rely on tools other than movie or newspaper portrayal to convince those with mental illness about the merits of this treatment.
The next issue in this series about mass media and mental illness will be posted next Tuesday August 19th.
I don’t think I’ve taken a blog to discuss ECT and it’s uses in modern society, but let me just say it is used in the psychiatric community when depression is resistant to the plethora of anti-depressants that are handed out today. It’s an ever continuing cycle and when the meds run out or no longer work, ECT is introduced into the client’s regimen. At some point, I will write more of an expose on ECT, but for now I just want to stick to my experience.
- Failure to respond to 1 adequate trial of an antidepressant
- Failure to respond to one or more adequate trials of antidepressants
- Failure to respond to 2 adequate trials of antidepressants
- Failure to respond to 2 adequate trials of antidepressants form different classes (e.g. SSRI and TCA)
- Failure to respond to 2 or more adequate antidepressant trials
- Failure to respond to 2 or more adequate antidepressants from different classes
Some authors and researchers object to the phrase failure to respond. They find this phrase blaming the patient. It is not the patients fault an antidepressant isn’t working or not working enough. Most of these researchers are authors of ECT publications. ECT is sometimes used as the last treatment option if antidepressants have failed. They prefer: pharmacotherapy treatment failure.
These six definitions were found in a systematic review of all randomized controlled trials on somatic treatment of treatment resistant depression. They found 233 references of which only 47 were RCT’s with unipolar depressed patients older than 18 years published in peer reviewed English Journals. Mostly publications about TRD is expert opinion on the subject. This publication is a systematic review.
In the majority of papers the information on the type of assessment for antidepressant resistance was not available. Two studies used a prospective assessment off TRD, 7 were retrospective assessed.
The majority of studies did not provide the maximum dose required to describe a previous treatment as a failure or success. 18 studies did not present information regarding requirements for prior treatment length.
Most studies did not use a thorough diagnostic evaluation, ideally performed with the use of a structured clinical interview, in case of treatment resistance.
A wide variety of terms has been used to decsribe TRD:
There is still an absence of definitive consensus about a general suitable definition for TRD. There is also a lack of how to assess the presence of TRD.
So what needs done is an international consensus about what is TRD and how should we assess it.
There is a clear need for an internationally shared framework of concepts and methods for the investigation of TRD that could reduce current idiosyncrasies and provide a reference system. Such a foundation is essential for the interpretation of research findings and for their translation to clinical practice.
What are your thoughts about this subject, do you use a definition?
One of my most read posts on this blog is:
9 Steps for Treatment Resistant Depression (TRD)
BERLIM, M., TURECKI, G. (2007). What is the meaning of treatment resistant/refractory major depression (TRD)? A systematic review of current randomized trialsâ˜†. European Neuropsychopharmacology, 17(11), 696-707. DOI: 10.1016/j.euroneuro.2007.03.009
This is the title of an article in the Washington Post online. Another with opinions from different professionals, psychiatrists and psychologists alike as well as patients view. This article put’s ECT in a historic perspective and also discusses a recent article in the JAMA which is described in this blog a few day ago.
Another short but concise introduction to ECT for patients can be found on this page of webMD. It is short but on this blog more posts about sites with information on ECT for patients can be found. Use the tags on the right column.
The information is reviewed by the department of psychiatry from the Cleveland Clinic.
Wikipedia has a lot of information about ECT. Also in the Dutch version thanks to one of the members of the WEN. Soon there will be a version on DVD. The new DVD will concentrate on about 2,000 articles, with emphasis on mostly unchangeable topics such as geography and literature.
The most valuable information to my opinion is the new initiative: Citizendium.Wiki with stricter editing rules and obligatory disclosure of editor’s real names, mostly professionals.
It also has information about ECT
In his commentary in the Journal of ECT Prof. Max Fink pleads for a ECT Accreditation Service (ECTAS) as in the United Kingdom. In the eighties and nineties of the previous century national surveys of actual practice of ECT in the U.K. revealed deficiencies in the practice of ECT. One third of the clinics did not meet the guideline standard, 41% still used outdated equipment. First in Scotland psychiatrists undertook a 3 year cycle of audits to systematically answer questions about patient demographics and outcome. Each ECT clinic was visited twice. In 2003 this initiative was followed in the U.K. Each ECT site was evaluated. Each site evaluation begins with team members completing a 284-item questionnaire assessing facilities, staff and training, consent, anesthesia, treatment and recovery procedures, and precautions and adherence to protocols. A visit by an assessment team (a clinician, a nurse , and an anaesthetist) to observe actual practice follows. Resurveys of evaluated sites are scheduled in a 3 year cycle. An update of ECTAS standards was put on the website in December 2006. An improvement of the quality of ECT in the UK developed. Is this also possible in the US he asks himself, or in The Netherlands I ask myself?