Factors That Influence Electroconvulsive Therapy Referrals

Dauenhauer, Laura E.; Chauhan, Preeti; Cohen, Bruce J.

doi:10.1097/yct.0b013e3181f9789c

Cited by 36 publications

(20 citation statements)

References 9 publications

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“…Psychiatrists' and patients' knowledge and attitudes about a physical therapy is correlate with therapeutic response [7,8]. Patients' misconceptions about a treatment modality are directly affected by their physicians' knowledge about such treatments [9].…”

Section: Introductionmentioning

confidence: 99%

Knowledge and Attitudes about Transcranial Magnetic Stimulation Among Psychiatrists in China

Deng

Gong

Lin

et al. 2020

Preprint

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Background: Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive form of brain stimulation. It has been used in many mental health institutions to treat mental disorders worldwide. However, comprehensive knowledge about rTMS is not yet widespread among psychiatrists. The present study assessed psychiatrists’ knowledge and attitudes about rTMS in China and investigated related factors.Methods: A quantitative observational cross-sectional study was conducted using an online survey. The sample consisted of 522 psychiatrists. Multinomial logistic regression and multiple linear regression analyses were used to explore factors that contributed to psychiatrists’ knowledge about rTMS. We also ascertained psychiatrists’ attitudes about rTMS and provide recommendations for the more widespread use of rTMS.Results: The majority of respondents (86.4%) reported having access to rTMS at their institution. A total of 379 psychiatrists (72.6%) knew that rTMS was approved by the United States Food and Drug Administration for treatment-resistant depression. Univariate logistic regression indicated that psychiatrists who were older, had a senior professional title, worked more years, had an onsite clinical rTMS program in their hospital, and received formal training in theory and application (all p < 0.05) were more likely to know that rTMS was approved by the Food and Drug Administration for the treatment of depression. The percentages of respondents who knew most or all indications, the mechanism of action, parameter settings, adverse reactions were 51.9%, 40.2%, 27.4%, and 41.4%. Linear regression showed that formal training in rTMS theory and practice were associated with higher knowledge scores (all p < 0.05). Most of the subjects had negative attitudes about using rTMS to treat mental disorders. When asked about their attitudes about continuing rTMS education, nearly all of the respondents indicated that they were willing to pursue continuing training in rTMS in the future. Conclusions: Many psychiatrists had an insufficient level of knowledge about rTMS and negative attitudes about rTMS. Psychiatrists who had formal rTMS training experience had higher levels of rTMS knowledge. rTMS training and relevant policy making should be strengthened.

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Section: Introductionmentioning

confidence: 99%

Knowledge and Attitudes about Transcranial Magnetic Stimulation Among Psychiatrists in China

Deng

Gong

Lin

et al. 2020

Preprint

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“…Two out of the four psychiatrists having referred patients for neurosurgical evaluations during their professional career belonged to this group suggesting a positive trend toward referrals in more informed respondents, mirroring the results of the ECT literature. 31,32 Also, seven out of the eight respondents who did not identify lack of knowledge as a barrier were psychiatrists, reflecting a lack of education on neurosurgical interventions during residency training.…”

Section: Discussionmentioning

confidence: 99%

“…being a doctor, higher perceived level of knowledge). 31,32 However, this study is the first to evaluate the attitudes and perceptions of psychiatrists and psychiatry residents regarding neurosurgical interventions, specifically DBS and AC, for treating psychiatric disorders. It aims to identify potential barrier to patient referral.…”

Section: Introductionmentioning

confidence: 99%

Psychiatric Neurosurgery: A Survey on the Perceptions of Psychiatrists and Residents

Cormier

Iorio-Morin

Mathieu

et al. 2019

Can. J. Neurol. Sci.

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ABSTRACT:Objectives: To evaluate the attitudes and perceptions of psychiatrists and psychiatry residents regarding neurosurgical procedures for treating psychiatric disorders and to identify potential barriers to patient referral. Methods: A survey consisting of 25 questions was created using SurveyMonkey and was distributed to psychiatrists and psychiatry residents in Quebec. The study was approved by the McGill University Health Center’s Research Ethics Board. Descriptive statistics and Friedman’s test were performed using SPSS software. Results: A total of 99 participants, including 64 residents and 35 psychiatrists, completed more than 75% of the survey and were included in data analysis. Overall, participants were significantly (p < 0.0005) more comfortable in referring patients suffering from treatment-resistant obsessive–compulsive disorder than from treatment-resistant major depressive disorder and preferred to refer patients for deep brain stimulation (DBS) rather than for anterior cingulotomy/capsulotomy (AC). Only 11.43% of psychiatrists had ever referred a patient for AC or DBS, and 34.69% of respondents felt that these procedures were dangerous. Lack of knowledge (82.83%) was viewed as the principal limiting factor, and 57.58% of respondents identified ≥6 different barriers to patient referral. The majority of participants (69.39%) were interested in improving their knowledge on psychiatric neurosurgery, and 82.65% felt that this subject should be included in the psychiatry residency curriculum. Conclusion: Overall, participants acknowledged having many limitations to referring patients for neurosurgical interventions. While informative conferences discussing neuromodulation/neuroablation could easily address many barriers, further studies are required to assess how these could change attitudes and patterns of referral.

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“…Also, decreasing stimulus intensity and decreasing the frequency and number of treatments may prove beneficial ( Payne and Prudic, 2009 ; Mankad, 2010 ). On the other hand, more professional education about ECT and related mental health laws for psychiatrists may increase the numbers of ECT prescriptions or referrals ( Finch et al, 1999 ; Dauenhauer et al, 2011 ).…”

Section: Discussionmentioning

confidence: 99%

ECT Has Greater Efficacy Than Fluoxetine in Alleviating the Burden of Illness for Patients with Major Depressive Disorder: A Taiwanese Pooled Analysis

Lin

Huang

Chen

2017

International Journal of Neuropsychopharmacology

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BackgroundThe burden of major depressive disorder includes suffering due to symptom severity, functional impairment, and quality of life deficits. The aim of this study was to compare the differences between electroconvulsive therapy and pharmacotherapy in reducing such burdens.MethodsThis was a pooled analysis study including 2 open-label trials for major depressive disorder inpatients receiving either standard bitemporal and modified electroconvulsive therapy with a maximum of 12 sessions or 20 mg/d of fluoxetine for 6 weeks. Symptom severity, functioning, and quality of life were assessed using the 17-item Hamilton Rating Scale for Depression, the Modified Work and Social Adjustment Scale, and SF-36. Side effects following treatment, including subjective memory impairment, nausea/vomiting, and headache, were recorded. The differences between these 2 groups in 17-item Hamilton Rating Scale for Depression, Modified Work and Social Adjustment Scale, quality of life, side effects, and time to response (at least a 50% reduction of 17-item Hamilton Rating Scale for Depression) and remission (17-item Hamilton Rating Scale for Depression ≤7) following treatment were analyzed.ResultsElectroconvulsive therapy (n=116) showed a significantly greater reduction in 17-item Hamilton Rating Scale for Depression, Modified Work and Social Adjustment Scale, and quality of life deficits and had significantly shorter time to response/remission than fluoxetine (n=126). However, the electroconvulsive therapy group was more likely to experience subjective memory impairment and headache.ConclusionsCompared with fluoxetine, electroconvulsive therapy was more effective in alleviating the burden of major depressive disorder and had a substantially increased speed of response/remission in the acute phase. Increased education and information about electroconvulsive therapy for clinicians, patients, and their families and the general public is warranted.

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Factors That Influence Electroconvulsive Therapy Referrals

Abstract: Patient referral for ECT was associated with the treating physicians' and patients' knowledge and attitudes about ECT and with the presence of specific logistical barriers. Attention to these factors by treating physicians might enhance access to ECT treatment.

Cited by 36 publications

References 9 publications

Knowledge and Attitudes about Transcranial Magnetic Stimulation Among Psychiatrists in China

Knowledge and Attitudes about Transcranial Magnetic Stimulation Among Psychiatrists in China

Psychiatric Neurosurgery: A Survey on the Perceptions of Psychiatrists and Residents

ECT Has Greater Efficacy Than Fluoxetine in Alleviating the Burden of Illness for Patients with Major Depressive Disorder: A Taiwanese Pooled Analysis

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