In his latest Psychology Today article "Patients Are Being Misinformed About Electroconvulsive Therapy," Professor John Read discusses how the "audit of patients' ECT information leaflets finds many gaps and errors."

To the surprise of many people, electroconvulsive therapy (ECT) is still used. In the UK, about 2,500 people every year undergo the procedure, which involves about ten electric shocks under general anaesthesia, to produce a seizure, over several weeks. Nobody knows how many people get ECT in the USA as there are no federal records. We do know, however, that there is massive variation between, and within, countries. Our recent audit in England found a 47-fold difference between the highest using and lowest using regions, suggesting that who gets ECT is a geographic lottery, determined by the personal opinions of local psychiatrists.

 
In a previous post, I summarised my 2019 review of the ECT research literature, with Professor Kirsch of Harvard Medical School, showing that there is no convincing evidence that ECT outperforms placebo in the short-term and no evidence at all that it has any long-term benefits or prevents suicide. We also summarised the evidence that it causes persistent memory loss for between 12 and 55 percent of patients.

 
With such a challenging risk-benefit ratio, one would assume that psychiatrists are particularly careful to make absolutely sure that potential recipients and their families are given comprehensive, evidence-based information about the pros and cons. The principle of informed consent is a cornerstone of the codes of ethics of all health professionals.

 
Nearly 20 years ago, however, in 2003, the UK’s National Institute for Health and Care Excellence found the information provided to patients totally inadequate. It recommended:

"National information leaflets should be developed through consultation with appropriate professional and user organisations to enable individuals and their carers/advocates to make an informed decision regarding the appropriateness of ECT for their circumstances. The leaflets should be evidence based, and include information about the risks of ECT and availability of alternative treatments [...]."

 
ECT Leaflets Omit Information and Include Inaccurate Statements
Our audit, published today,1 finds that NHS mental health services and the Royal College of Psychiatrists have ignored this recommendation for nearly two decades.

Freedom of Information Act requests were sent to 51 NHS Trusts for a copy of their ECT information leaflet. Thirty-six (71 percent) provided leaflets. The number of accurate pieces of information, from a possible 29, ranged from four to 20, with a mean of 12.8.

 
The most commonly omitted information was:

• there are different forms of ECT, with different risks of memory loss (mentioned by just 14 trusts);
• psychological therapy should be tried first (12 Trusts);
• cardiovascular side effects (6);
• lack of long-term benefits (6);
• patients’ right to take 24 hours to consider giving consent (1);
• memory loss is higher in women and older people (0).

To read the rest of the article detailing the most common inaccurate statements given to patients by their doctors about ECT, please go to "Patients Are Being Misinformed About Electroconvulsive Therapy"