David H Myers1. 1. Shelton Hospital, Shrewsbury, UK. dhmyers@green113.wanadoo.co.uk
Abstract
OBJECTIVE: To ascertain patients' experience of electroconvulsive therapy (ECT) using a questionnaire having these features: short so to be acceptable to the elderly and the depressed; ascertaining experience, not opinions; coming from a 'neutral' source; and analyzed by methods that do not impose an arbitrary scale on ordinal response categories. METHOD: Two hundred eighty-eight traceable patients consecutively treated with ECT were surveyed, the majority by post. One hundred forty-eight replied. RESULTS: The conviction, a median of 4 years after ECT, that side effects persisted was related to current depression and, inversely, to age, but not to the number of ECT given. Current depression was also associated with a less favorable account of emotional support during ECT. Formal legal status had no effect on any of the answers, but refusal of, or agreement to ECT on sufferance, was linked to a relatively unfavorable view of it. Not all patients regarded the decision to give them ECT compulsorily wrong on principle; some judged by results. CONCLUSIONS: The degree of current depression contributes to several aspects of the patient's view of ECT given a median of 4 years earlier. The belief that side effects persist has a complex basis; but the importance of this belief is not thereby diminished. Legal compulsion of treatment adds its own quota of contention which can be mitigated, but not entirely dispelled, by careful adherence to the law.
OBJECTIVE: To ascertain patients' experience of electroconvulsive therapy (ECT) using a questionnaire having these features: short so to be acceptable to the elderly and the depressed; ascertaining experience, not opinions; coming from a 'neutral' source; and analyzed by methods that do not impose an arbitrary scale on ordinal response categories. METHOD: Two hundred eighty-eight traceable patients consecutively treated with ECT were surveyed, the majority by post. One hundred forty-eight replied. RESULTS: The conviction, a median of 4 years after ECT, that side effects persisted was related to current depression and, inversely, to age, but not to the number of ECT given. Current depression was also associated with a less favorable account of emotional support during ECT. Formal legal status had no effect on any of the answers, but refusal of, or agreement to ECT on sufferance, was linked to a relatively unfavorable view of it. Not all patients regarded the decision to give them ECT compulsorily wrong on principle; some judged by results. CONCLUSIONS: The degree of current depression contributes to several aspects of the patient's view of ECT given a median of 4 years earlier. The belief that side effects persist has a complex basis; but the importance of this belief is not thereby diminished. Legal compulsion of treatment adds its own quota of contention which can be mitigated, but not entirely dispelled, by careful adherence to the law.