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跳圈游戏:关于使用精神科电疗干预的障碍和其他伦理问题。

Jumping through the hoops: Barriers and other ethical concerns regarding the use of psychiatric electroceutical interventions.

机构信息

Center for Neural Engineering, Department of Science and Mechanics and Rock Ethics Institute, Pennsylvania State University, University Park, W-316 Millennium Science Complex, PA 16802, United States.

College of Human Medicine, Michigan State University, East Lansing, MI, United States.

出版信息

Psychiatry Res. 2022 Jul;313:114612. doi: 10.1016/j.psychres.2022.114612. Epub 2022 May 11.

Abstract

Stakeholders' perceptions of barriers to and other ethical concerns about using psychiatric electroceutical interventions (PEIs), interventions that use electrical or magnetic stimuli to treat psychiatric conditions like treatment-resistant depression (TRD), may influence the uptake of these interventions. This study examined such perceptions among psychiatrists, patients with depression, and members of the public. We conducted semi-structured qualitative interviews with 16 members of each group to examine their views on practical barriers and ethical concerns. We used qualitative content analysis to identify relevant themes, and compared findings across stakeholder groups. Access limitations to the interventions, including cost and availability of the interventions, cut across all PEIs-including those that are still experimental, and were raised by all groups. Most participants across all groups raised concerns about informed consent, in terms of receiving adequate, appropriate, and understandable information. Our results suggest that these three stakeholder groups perceive similar structural and attitudinal barriers to, and have similar ethical concerns about, using PEIs for TRD. These results identify key issues that must be addressed for the full potential of PEIs to be realized. Future research with larger samples will help to better understand how to address these barriers to treatment for individuals with TRD.

摘要

利益相关者对使用精神科电疗干预(PEIs)的障碍和其他伦理问题的看法,这些干预措施使用电或磁刺激来治疗精神疾病,如治疗抵抗性抑郁症(TRD),可能会影响这些干预措施的采用。本研究调查了精神科医生、抑郁症患者和公众成员的这些看法。我们对每个组的 16 名成员进行了半结构化的定性访谈,以检查他们对实际障碍和伦理问题的看法。我们使用定性内容分析来确定相关主题,并比较了利益相关者群体之间的发现。所有组的参与者都提出了对干预措施的获取限制的担忧,包括干预措施的成本和可及性,这些都跨越了所有的 PEIs,包括那些仍处于实验阶段的,也跨越了所有组。大多数参与者都对知情同意提出了担忧,包括获得充分、适当和可理解的信息。我们的研究结果表明,这三个利益相关者群体对使用 PEIs 治疗 TRD 的相似的结构性和态度障碍有类似的伦理担忧。这些结果确定了必须解决的关键问题,以便充分发挥 PEIs 的潜力。未来更大样本的研究将有助于更好地了解如何解决这些对 TRD 患者的治疗障碍。

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