Factors Influencing Staff’s Attitude Toward Electroconvulsive Therapy

Scholz-Hehn, Anne Deborah; Müller, J; Deml, Ruben; Methfessel, Isabel; Zilles, David; Hädrich, Florian; Hecht, G. M.; Luedecke, Daniel; Gornisch, Janina; H, Albrecht; Stumm, Laura; Freundlieb, Nils

doi:10.1097/yct.0000000000000544

Cited by 3 publications

(2 citation statements)

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“…Studies that examined the stigma of ECT concluded that orientation, knowledge, and exposure to ECT tend to change attitudes toward ECT 42,47,67 . Contact with patients who have undergone ECT seems to be also helpful 68 . A focus group suggested that providing factual information and handouts helps reduce stigma 69 .…”

Section: Discussionmentioning

confidence: 99%

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The Nomenclature of Electroconvulsive Therapy

Sidhom

Omar

2020

J ECT

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Electroconvulsive therapy (ECT) is an established but stigmatized psychiatric treatment. The term ECT reflects the treatment's modality and action. Several authors proposed different names for ECT to deal with stigma; however, available literature that promoted different names did not address the risk/benefit ratio or offer evidence-based approach to the efficacy of this approach. We aim to examine proposed names for their specificity, accuracy, understandability, and popularity. In addition, we aim to find evidence-based methods to combat the ECT-related stigma. We reviewed the literature relating to the proposed names using snowballing technique for literature search. Known ECT alternative names were used for search, and whenever another name appears, it was added to our search list. We conducted Medline, PsycINFO, Google Scholar, and PubMed search to check for popularity and cross examine whether proposed terms refer back to ECT. We searched for ECT and stigma, to find evidence for methods to tackle ECT-related stigma. Once, the search stopped yielding newer ideas, we stopped the search at a point of saturation, where no more ideas where generated. Our name search yielded 14 terms. Nine names avoided "electricity" and "convulsion," because of perceived associated stigma. Presence of different terminology can affect the clarity of patient-doctor communication, with no evidence of added benefit. Alternative names may affect doctor-doctor communication about this treatment. We concluded that it is safer to retain the term ECT for the sake of consistency and clarity of communication. Education and experience are evidence-based effective methods of tackling ECT-related stigma.

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Section: Discussionmentioning

confidence: 99%

“…42,47,67 Contact with patients who have undergone ECT seems to be also helpful. 68 A focus group suggested that providing factual information and handouts helps reduce stigma. 69 Counseling that focuses on stigma management and ECT seems to help inpatients.…”

Section: Effective Ways Of Managing Stigmamentioning

confidence: 99%

The Nomenclature of Electroconvulsive Therapy

Sidhom

Omar

2020

J ECT

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Stellenwert der Elektrokonvulsionstherapie (EKT) in der forensischen Psychiatrie

Besse

Schomburg

Simon³

et al. 2020

Nervenarzt

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Hintergrund und Ziel der Arbeit Für die Elektrokonvulsionstherapie (EKT) liegen Leitlinienempfehlungen zur Behandlung schwerer affektiver und psychotischer Erkrankungen vor, wie sie auch bei Patienten im Maßregelvollzug (MRV) vorkommen. Über die Anwendung der EKT in der forensischen Psychiatrie existieren jedoch keinerlei systematisch erhobene Daten. Ziel der vorliegenden Arbeit ist eine Erhebung des Ist-Zustands sowie des geschätzten Bedarfs an EKT im MRV. Material und Methoden Es wurde ein Fragebogen zur Erhebung der aktuellen Anwendung sowie der Einschätzung des Bedarfs an EKT in dieser Population entwickelt. Dieser wurde elektronisch und bei Bedarf postalisch an die forensischen Kliniken in Deutschland versendet. Ergebnisse Wir erhielten Antwort von 52 Kliniken (66 %). 29 der Kliniken gaben an, Patienten mit EKT behandeln zu können. Eine Behandlungsindikation wurde klinikübergreifend für 3,4 % der untergebrachten Patienten gesehen. In einem Jahr (2018) wurden insgesamt 32 EKT-Behandlungen an 12 Kliniken des Maßregelvollzugs mit durchschnittlich guter Wirksamkeit (Ø CGI‑I 2,32) durchgeführt. Häufigste Begründung für die fehlende Anwendung der EKT waren mangelnde strukturelle Voraussetzungen. Jeweils etwa ein Drittel der Kliniken sehen einen mittleren bzw. hohen Bedarf an EKT im MRV. Diskussion Die EKT kommt im MRV in Deutschland aktuell nur sehr begrenzt zum Einsatz. Auffällig ist, dass die Anzahl der durchgeführten Behandlungen etwa um den Faktor 8 hinter der Indikationshäufigkeit zurücksteht. Ungeachtet dessen sehen zwei Drittel der Kliniken einen mittleren bis hohen Bedarf, womit eine Unterversorgung mit EKT im MRV zu bestehen scheint.

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Risk Assessment of Electroconvulsive Therapy in Clinical Routine: A 3-Year Analysis of Life-Threatening Events in More Than 3,000 Treatment Sessions

Hajak

Hajak²,

Ziegelmayer³

et al. 2021

Front. Psychol.

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Background: Extensive research has reported that electroconvulsive therapy (ECT) can be highly effective in approximately 80% of patients suffering from depression. Its clinical use is mainly limited by historical objections and the concern about unwanted adverse effects (AEs), including serious and potentially life-threatening adverse events (pLTAEs), induced either by ECT or by anesthesia. Objective risk estimation is, therefore, a decisive factor in determining an indication for ECT.Methods: This paper presents a retrospective analysis of 3-year safety protocols and patient files of 157 patients who received a total of 3,106 ECT applications in a psychiatric inpatient setting at a psychiatric community hospital. This patient group comprises 5.3% of inpatients admitted with comparable diagnoses. Adverse events were analyzed from standardized safety protocols and patient files with a focus on pLTAEs.Results: Adverse events were reported for 30 (19.1%) of the 157 participants during 39 (6.1%) of 641 hospital stays. Serious pLTAEs occurred during three electroconvulsive stimulations in three patients, who needed action through the administration of medication or mechanical respiration. No patient suffered permanent damage to health, and no patient died. The incidence of these and other AEs was independent of sex, age, and diagnosis of patients, and anesthesia medication. Minor AEs occurred more often with higher stimulus doses and an increasing number of treatments.Conclusion: The low incidence rate of 0.097% of serious pLTAEs that require medical action may allow the conclusion that ECT is a rather safe treatment when performed in a controlled setting. The beneficial risk profile of ECT performed in the standard care of psychiatric hospitals suggests a more generous indication of this treatment method. We recommend that ECT facilities collect individual safety data to allow a reliable judgment of their institutional ECT risk profile.

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Factors Influencing Staff’s Attitude Toward Electroconvulsive Therapy

Cited by 3 publications

References 14 publications

The Nomenclature of Electroconvulsive Therapy

The Nomenclature of Electroconvulsive Therapy

Stellenwert der Elektrokonvulsionstherapie (EKT) in der forensischen Psychiatrie

Risk Assessment of Electroconvulsive Therapy in Clinical Routine: A 3-Year Analysis of Life-Threatening Events in More Than 3,000 Treatment Sessions

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