Electroconvulsive therapy: a review of knowledge, experience and attitudes of patients concerning the treatment.

OBJECTIVES

Despite its proven efficacy 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

Seventy-five 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.