Download this Research Paper in word format. Evidence has been cited suggesting that ECT is particularly efficacious with psychotic depression.
This article has been cited by other articles in PMC. Electroconvulsive therapy is one of the most controversial treatments in medicine. Opinions are often polarised; some consider electroconvulsive therapy to be effective and potentially lifesaving whereas others regard it as unhelpful and harmful and campaign energetically for it to be banned.
Both reviews reveal the limitations of the primary studies and the need for genuinely collaborative high quality research—rather than research done by consumers for consumers and by clinicians for clinicians resulting in research with limited general credibility. Nonetheless both reviews produced some useful results.
Of course this may be explained by differences in the selection of the populations sampled or, as the authors suggest, by differences in the focus of the questions and the way they were asked.
The review of randomised trials found a reasonable body of evidence on the effects of electroconvulsive therapy in depressive disorder, but less on mania and schizophrenia. Treatment with electroconvulsive therapy was more effective than drug treatment in the short term, bilateral stimulation was more effective than unilateral, and high dose more effective than low dose.
Most of the trials, however, were old and small. Cognitive functioning was not measured consistently across the trials and pooled analyses were not possible.
Very few trials investigated the possibility of long term cognitive impairment but those that did suggested that this was not a substantial problem. In view of the limited reliable long term evidence it is understandable that there should be residual concern about the possible long term adverse effects of electroconvulsive therapy, and this should be reflected in the information given to patients.
The Royal College of Psychiatrists appealed that the recommendations go beyond the evidence and will prevent patients who would benefit from the treatment from being able to receive it. For too long electroconvulsive therapy has been a neglected service with widespread unexplained variations in practice and a low priority with managers: We predict that most parties will be reasonably satisfied with the NICE appraisal.
Those concerned about potential overuse of the treatment can be reassured with the restrictions, increased safeguards, and improved consent procedures. Clinicians with the responsibility for helping the most severely ill patients will still have access to an effective treatment.
So far, the process appears to have resulted in an approach that is both evidence based and broadly acceptable to most stakeholders. If this indeed is the result, it will be a substantial achievement in such a difficult area of clinical practice and a finely judged performance by NICE.
SC and JG are both psychiatrists who were involved in the UK Department of Health systematic review of randomised trials of electroconvulsive therapy. Tharyan P, Adams CE. Electroconvulsive therapy for schizophrenia.
Cochrane Database Syst Rev ; 1: National Institute for Clinical Excellence. Guidance on the use of electroconvulsive therapy. Appraisal of electroconvulsive therapy.
Decision of the appeal panel. Glen T, Scott AI. Variation in rates of electroconvulsive therapy use among consultant teams in Edinburgh J Affect Disord ;"cryptography provider" means any person who provides or who proposes to provide cryptography services or products in the Republic; " cryptography service" means any service which is provided to a sender or a recipient of a data message or to anyone storing a data message, and which is designed to facilitate the use of cryptographic techniques for the purpose of ensuring—.
Psychiatry On-Line - The worl'ds first online medical journal from - One of the medical journals, dental, psychiatric and veterinary journals from Priory Lodge Education Ltd. Declaration of Interest: Neither author has any financial conflicts of interest in relation to this paper.
KEY WORDS: ECT, evidence-based medicine, literature review, cost-benefit analysis. Received – Final version received – Accepted Citation Machine™ helps students and professionals properly credit the information that they use.
Cite sources in APA, MLA, Chicago, Turabian, and Harvard for free. ECT (electroconvulsive therapy, shock treatment, electroshock) involves the application of two electrodes to the head to pass electricity through the brain with the goal of .
Electroconvulsive Therapy News and Research RSS Electroconvulsive therapy (ECT) involves the induction of a seizure for therapeutic purposes by the administration of a variable frequency electrical stimulus shock via electrodes applied to the scalp.