Electroconvulsive therapy: the practice and training needs of referring psychiatrists in the United Kingdom and Republic of Ireland.

This study aims to gain a greater understanding of the clinical practice and training needs of psychiatrists who prescribe electroconvulsive therapy (ECT), including knowledge about ECT, obtaining informed consent, and the monitoring of patients after ECT. Four hundred ninety psychiatrists who refer patients for ECT were sent questionnaires as part of reviews conducted by the ECT Accreditation Service, and 56% responded. Data were analyzed using descriptive statistics and thematic analysis. Nearly all felt that they had adequate knowledge about ECT with 35% recognizing further training needs. Psychiatrists were likely to find difficulty explaining to patients more about how ECT works and the possibility of long-term cognitive side effects than the benefits of ECT. The main areas of training need are the obtaining of informed consent, including the choice between unilateral and bilateral ECT, and the assessment of cognitive function during and after the course. The study also reveals the need for further research into long-term cognitive side effects of ECT and the need for a reliable cognitive assessment tool for measuring persistent or autobiographical memory deficits.