Patients Are Still Being Misinformed About Electroconvulsive Therapy

From Psychology Today/John Read, PhD: “Two years ago I reported, here, on our survey of patient information leaflets about electroconvulsive therapy (ECT) in England. On the basis of leaflets from 36 of 51 clinics (71%), we concluded that informed consent is not being complied with, because: ‘Patients are being misled about the risks they are taking and the limited nature of ECT’s benefits’.

This month sees the publication of two follow up papers. The first¹ is a replication of our first audit, in ECT clinics in Northern Ireland, Scotland and Wales . . . The idea for the study came from our co-author Lisa Morrison who has had 96 ECTs herself.

The results were almost as disappointing as the England audit. The number of accurate statements (out of a possible 29) ranged from seven to 20, with an average of 16.9. The most frequently omitted crucial pieces of information were: cardiovascular risks (included by only five leaflets), that it is not known how ECT works (3), risk of mortality (2), risks from multiple general anaesthetic procedures (2), how to access a legal advocate (2), and that that there is no evidence of long-term benefits (1).

The leaflets also made between six and nine inaccurate statements (out of 11) with an average of 7.0. Nineteen minimised memory loss, blamed the memory loss on depression, claimed that ECT is the ‘most effective treatment’, and asserted it has very high response rates without mentioning similar placebo response rates. All 23 leaflets told patients that ECT saves lives, although almost all studies either find no difference between ECT and non-ECT groups, or that the ECT group has higher suicide rates.”

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