Impact on Psychiatric Interns of Watching Live Electroconvulsive Treatment

Gazdag, Gábor; Sebestyén, Gábor; Ungvári, Gábor S.; Tolna, Judit

doi:10.1176/appi.ap.33.2.152

Cited by 14 publications

(9 citation statements)

References 8 publications

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“…UK students reported no fears of abuse of ECT by psychiatrists, unlike some 30% of their counterparts in Iraq and Egypt 152. Negative attitudes towards ECT may be attributable to mass media and movie depictions 148,153, whereas the UK students were more likely to have observed actual cases treated with ECT 152,154.…”

Section: Results Of the Review Of Knowledgementioning

confidence: 91%

WPA guidance on how to combat stigmatization of psychiatry and psychiatrists

et al. 2010

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Section: Results Of the Review Of Knowledgementioning

confidence: 91%

WPA guidance on how to combat stigmatization of psychiatry and psychiatrists

et al. 2010

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“…In one study of depressed inpatients, those viewing ECT favorably were more likely to receive it, indicating that patient preference influences ECT use (29). Limited data indicate that those who receive ECT develop more positive impressions of the procedure (29, 30) and that providers who are taught about ECT similarly become more supportive of its use (31), suggesting that declining use of ECT may contribute to a cycle of unfamiliarity and more negative attitudes. Nonetheless, if declining patient or provider interest were the principal cause of changes in utilization of ECT, we would expect declines in use of ECT where it was available, rather than the stable use we observed.…”

Section: Discussionmentioning

confidence: 99%

Declining Use of Electroconvulsive Therapy in United States General Hospitals

Case

Bertollo

Laska

et al. 2013

Biological Psychiatry

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Background Falling duration of psychiatric inpatient stays over the past two decades and recent recommendations to tighten federal regulation of electroconvulsive therapy (ECT) devices have focused attention on trends in ECT use, but current national data have been unavailable. Methods We calculated the annual number of inpatient stays involving ECT and proportion of general hospitals conducting the procedure at least once in the calendar year using a national sample of discharges from 1993–2009. We estimated adjusted probabilities that inpatients with severe recurrent major depression (N=465,646) were treated in a hospital which conducts ECT and, if so, received the procedure. Results The annual number of stays involving ECT fell from 12.6 to 7.2 per 100,000 adult US residents, driven by dramatic declines among the elderly, while the percentage of hospitals conducting ECT decreased from 14.8% to 10.6%. The percentage of stays for severe recurrent major depression in hospitals which conducted ECT fell from 70.5% to 44.7%, while receipt of ECT where conducted declined from 12.9% to 10.5%. For depressed inpatients, the adjusted probability that the treating hospital conducts ECT fell 34%, while probability of receiving ECT was unchanged for patients treated in facilities which conducted the procedure. Adjusted declines were greatest for the elderly. Throughout the period inpatients from poorer neighborhoods or who were publicly- or un-insured were less likely receive care from hospitals conducting ECT. Conclusions ECT use for severely depressed inpatients has fallen markedly, driven exclusively by a decline in the probability that their hospital conducts ECT.

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“…7 Formal education about ECT during residency training or through later continuing medical education could provide physicians with the opportunity to learn about other potential indications for ECT beyond major depressive disorder, including bipolar depression, mania, and mixed states, as well as depression complicating neurological illnesses such as Parkinson disease and cerebrovascular disease. Although most of the psychiatrists surveyed demonstrated a basic knowledge of ECT, as many as 11% reported having received no formal ECT training and 4% reported not even feeling comfortable discussing ECT as a treatment option with their patients.…”

Section: Discussionmentioning

confidence: 99%

“…[ Despite this, ECT remains underused, which is concerning given the prevalence of depression and its substantial morbidity, mortality, and financial impact on society. 7,8 This body of research indicates that education and experience with ECT are associated with more favorable perceptions of the procedure. 5,6 Other studies have examined the relative lack of knowledge about the procedure by medical students, psychiatry residents, and affiliated mental health professionals.…”

mentioning

confidence: 99%