An independent audit of electroconvulsive therapy patient information leaflets in Northern Ireland, Scotland and Wales.
adverse effects
electroconvulsive therapy
ethics
informed consent
Journal
Psychology and psychotherapy
ISSN: 2044-8341
Titre abrégé: Psychol Psychother
Pays: England
ID NLM: 101135751
Informations de publication
Date de publication:
12 2023
12 2023
Historique:
revised:
14
06
2023
received:
09
11
2022
accepted:
21
06
2023
medline:
7
11
2023
pubmed:
19
7
2023
entrez:
19
7
2023
Statut:
ppublish
Résumé
To evaluate the accuracy of patient information leaflets about electroconvulsive therapy (ECT) used in Northern Ireland, Scotland and Wales, and their compliance with the principle of informed consent. To replicate an audit in England, Freedom of Information Act requests were sent to the 26 providers of ECT for their ECT patient information leaflet. These were scored, by two independent raters, on the same 40-item accuracy measure used in the England audit. The number of accurate statements (out of a possible 29) ranged from seven to 20, with a mean of 16.9. The most frequently omitted statements included: cardiovascular risks (mentioned by 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 made between six and nine inaccurate statements (out of 11) with a mean 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 wrongly told patients that ECT saves lives. Electroconvulsive therapy information leaflets in these three nations are barely more accurate than those in England and do not comply with the ethical principle of informed consent. Patients and families across the UK are systematically being misled about the risks they are taking and the limited nature of ECT's benefits.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
885-901Informations de copyright
© 2023 The Authors. Psychology and Psychotherapy: Theory, Research and Practice published by John Wiley & Sons Ltd on behalf of The British Psychological Society.
Références
American Psychiatric Association. (2001). The practice of ECT: A taskforce report (2nd ed.). APA.
Bassa, A., Sagues, T., Porta-Casteras, D., Serra, P., Martinez-Amoros, E., Palao, D., Cano, M., & Cardoner, N. (2021). The neurobiolgical basis of cogntive side effects of electroconvulsive therapy: a systmeatic review. Brain Sciences, 11, 1273.
Benbow, S. (2004). Adverse effects of ECT. In D. Scott (Ed.), The ECT handbook (2nd ed.). Royal College of Psychiatrists.
Chen, X., Fu, Y., Zou, Q., Zhang, Y., Qin, X., Tian, Y., Yan, Y., Chen, Q., Zou, L., Zhao, B., & Li, X. (2022). A retrospective case series of electroconvuslive therapy in the management of depression and suicidal symptoms in adolscents. Brain and Behavior, 12, e2795.
Driver and Vehicle Licensing Agency. (2022). Assessing fitness to drive. https://www.gov.uk/guidance/appendices-assessing-fitness-to-drive#appendix-e-important-notes-concerning-psychiatric-disorders
Dubey, C. (2017). ECT and brain damage: Survey of the evidence from a philosophical promontory. Ethical Human Psychology and Psychiatry, 19, 24-50.
Duma, A., Maleczek, M., Panjikaran, B., Herkner, H., Karrison, T., & Nagele, P. (2019). Major adverse cardiac events and mortality associated with electroconvulsive therapy: A systematic review and meta-analysis. Anesthesiology, 130, 83-91.
ECTAS. (2022). ECT accreditation service. Royal College of Psychiatrists. https://www.rcpsych.ac.uk/improving-care/ccqi/quality-networks-accreditation/ectas
Food and Drug Administration. (2011). Executive summary for January 27-28 meeting of the neurological devices panel to discuss the classification of ECT. FDA.
Food and Drug Administration. (2020). Code of Federal Regulations, 21, 8 (H). https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=882.5940
Fosse, R., & Read, J. (2013). Electroconvulsive treatment: Hypotheses about mechanisms of action. Frontiers in Psychiatry, 4, 94-103.
Gergel, T., Howard, R., Lawrence, R., & Seneviratne, T. (2021). Time to acknowledge good electroconvulsive therapy research. Lancet Psychiatry, 8, 1032-1033.
Gregory, S., Shawcross, C., & Gill, D. (1985). The Nottingham ECT study. British Journal of Psychiatry, 146, 520-524.
Harrop, C., Read, J., & Geekie, J. (2023). Efforts to improve accuracy of information about electroconvulsive therapy given to patients and families. Ethical Human Psychology and Psychiatry. In press.
Harrop, C., Read, J., Geekie, J., & Renton, J. (2021). How accurate are ECT patient information leaflets provided by mental health services in England and the Royal College of psychiatrists? An independent audit. Ethical Human Psychology and Psychiatry, 23, 5-24.
Johnstone, L., & Cunliffe, S. (2020). Call for an independent review into the practice of ECT. Council for Evidence Based Psychiatry, 7 http://cepuk.org/2020/09/07/blog-call-for-an-independent-review-into-the-practice-of-ect/
Jorgensen, M., Rozing, M., Kellne, C., & Osler, M. (2020). Electroconvulsive therapy, depression severity and mortality data from the Danish National Patient Registry. Journal of Psychopharmacology, 34, 273-279.
Landis, J., & Koch, C. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159-174.
Lindblad, L., Nordenskjöld, A., Otterbeck, A., & Nordenskjöld, A. (2023). Risk factors for mortality of medical causes within 30 days of electroconvulsive therapy. Journal of Affective Disorders, 320, 527-533.
Linstone, H., & Turoff, M. (1975). The Delphi method: Techniques and applications. Addison-Wesley.
McGough, P. (2020). Health professionals renew calls for suspension of ECT. Freeths. https://individuals.freeths.co.uk/post/102gaye/health-professionals-renew-calls-for-suspension-of-ect
McGough, P. (2021). NHS trust used ECT 3 times more than national average. Freeths. https://individuals.freeths.co.uk/post/102gtnb/nhs-trust-used-ect-3-times-more-than-national-average
Meechan, C., Laws, K., Young, A., McLoughlin, D., & Jauhar, S. (2021). A critique of narrative reviews of the evidence-base for ECT in depression. Social Psychiatry and Psychiatric Epidemiology, 31, e10.
Mezei, G., Lau, E., Pace, N., Schenk, J., & Kheifets, L. (2022). Receipt of electroconvulsive therapy and subsequent development of amyotrophic lateral sclerosis: A cohort study. Bioelectromagnetics., 43, 81-89. https://doi.org/10.1002/bem.22389
Morrison, L. (2021). Electroconvulsive therapy: 'I have no memory of a year of my life'. BBC, Northern Ireland. https://www.bbc.co.uk/news/av/uk-northern-ireland-58800716
Morrison, L. (2022). Lisa Morrison's ECT story. In Morrison, L, Life after ECT. https://lifeafterect.com/loss-anger-lisa-morrisons-ect-story-part-1/
Munk-Olsen, T., Laursen, T., Videbech, P., Mortensen, P., & Rosenberg, R. (2007). All-cause mortality among recipients of electroconvulsive therapy: Register-based cohort study. British Journal of Psychiatry, 190, 435-439.
National Institute for Health and Care Excellence. (2003). Guidance on the use of ECT. https://www.nice.org.uk/guidance/ta59
Peltzman, T., Shiner, B., & Watts, B. (2020). Effects of electroconvulsive therapy on short-term suicide mortality in a risk-matched patient population. Journal of ECT, 36, 187-192.
Pippard, J., & Ellam, L. (1981). ECT in Great Britain. Gaskell.
Rasmussen, K. (2009). Sham electroconvulsive therapy studies in depressive illness: A review of the literature and consideration of the placebo phenomenon in electroconvulsive therapy practice. Journal of ECT, 25, 54-59.
Read, J. (2022). Response to yet another defence of ECT despite the absence of robust efficacy and safety evidence. Epidemiology and Psychiatric Sciences, 31, e13.
Read, J., & Arnold, C. (2017). Is electroconvulsive therapy for depression more effective than placebo? A systematic review of studies since 2009. Ethical Human Psychology and Psychiatry, 19, 5-23.
Read, J., & Bentall, R. (2010). The effectiveness of electroconvulsive therapy: A literature review. Epidemiology and Psychiatric Sciences, 19, 333-347. https://doi.org/10.1017/s1121189x00000671
Read, J., Bentall, R., Johnstone, L., Fosse, R., & Bracken, P. (2013). Electroconvulsive therapy. In J. Read & J. Dillon (Eds.), Models of madness: Psychological, social and biological approaches to psychosis (2nd ed., pp. 90-104). Routledge.
Read, J., Cunliffe, S., Jauhar, S., & Mcloughlin, D. (2019). Should we stop using electroconvulsive therapy? British Medical Journal, 364, k5233.
Read, J., Harrop, C., & Geekie, J. (2022). Time to acknowledge the bias of some ECT researchers and defenders. Lancet Psychiatry, 9(2), e9.
Read, J., Harrop, C., Geekie, J., & Cunliffe, S. (2022). Response to the Royal College of Psychiatrists' critique of our audit of ECT usage. Psychology and Psychotherapy: Theory, Research and Practice, 95, 617-620.
Read, J., Harrop, C., Geekie, J., & Renton, J. (2018). An audit of ECT in England 2011-2015: Usage, demographics, and adherence to guidelines and legislation. Psychology and Psychotherapy: Theory, Research and Practice, 91, 263-277.
Read, J., Harrop, C., Geekie, J., Renton, J., & Cunliffe, S. (2021). A second independent audit of ECT in England: Usage, demographics, consent, and adherence to guidelines and legislation in 2019. Psychology and Psychotherapy: Theory, Research and Practice, 94, 603-619.
Read, J., Kirsch, I., & Mcgrath, L. (2019). Electroconvulsive therapy for depression: A review of the quality of ECT vs sham ECT trials and meta-analyses. Ethical Human Psychiatry and Psychology, 21, 64-103.
Read, J., & Moncrieff, J. (2022). Depression: Why drugs and electricity are not the answer. Psychological Medicine, 52, 1401-1410.
Read, J., Ross, C., & Timimi, S. (2023). A study of ECT on 278 children and adolescents: Methodological, conceptual and ethical concerns. Brain and Behavior, 13, e2866.
Robertson, H., & Pryor, R. (2006). Memory and cognitive effects of ECT: Informing and assessing patients. Advances in Psychiatric Treatment, 12, 228-238.
Rose, D., Fleischmann, P., Wyke, S. T., Leese, J., & Bindmann, J. (2003). Patients' perspectives of electroconvulsive therapy: Systematic review. British Medical Journal, 326, 1363-1366.
Ross, C. (2006). The sham ECT literature: Implications for consent to ECT. Ethical Human Psychology and Psychiatry, 8, 17-28.
Royal College of Psychiatrists. (2022a). Electroconvulsive therapy. RCP. https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/ect
Royal College of Psychiatrists. (2022b). ECTAS Member Clinics. https://www.rcpsych.ac.uk/improving-care/ccqi/quality-networks-accreditation/ectas/ectas-members
Sackeim, H., Prudic, J., Fuller, R., Keilp, J., Lavori, P., & Olfson, M. (2007). The cognitive effects of ECT in community settings. Neuropsychopharmocology, 32, 244-254.
Schauder, B., Malcolm, T., Tan, A., Digant, D., Peterkin, A., & Taylor, K. (2022). Correlates of electroconvulsive therapy with neurocognitive functioning, subjective memory and depression. Journal of Affective Disorders Reports, 10, 100429. https://doi.org/10.1016/j.jadr.2022.100429
Scottish ECT Accreditation Network. (2017). ECT in Scotland - A guide to electroconvulsive therapy - The latest evidence. SEAN.
Scottish ECT Accreditation Network. (2019). SEAN annual report 2019. SEAN. https://www.sean.org.uk/AuditReport/_docs/2019-11-26-SEAN-Report.pdf?2.
Shiwach, R., Reid, W., & Carmody, T. (2001). An analysis of reported deaths following electroconvulsive therapy in Texas, 1993-1998. Psychiatric Services, 52, 1095-1097.
Sivasanker, V., Thompson, P., & Baugh, C. (2021). ECTAS response to ‘a second independent audit of electroconvulsive therapy in England, 2019: Usage, demographics, consent and, adherence to guidelines and legislation’. Psychology and Psychotherapy: Theory, Research and Practice, 95, 615-616.
Somatics. (2018). Regulatory update to Thymatron system IV instruction manual. http://www.thymatron. com/downloads/System_IV_Regulatory_Update.pdf
Tecoult, E., & Nathan, N. (2001). Morbidity in ECT. European Journal of Anaesthesiology, 18, 511-519.
Tsai, J., Peltzman, T., Watts, B., & Shiner, B. (2021). Effects of electroconvulsive therapy on suicidal behavior and emergency department use among homeless veterans: A propensity score-matched study. Journal of Clinical Psychiatry, 82, 21m13935. https://doi.org/10.4088/JCP.21m13935
Vann Jones, S., & McCollum, R. (2019). Subjective memory complaints after electroconvulsive therapy: Systematic review. British Journal of Psychiatry Bulletin, 43, 73-80. https://doi.org/10.1192/bjb.2018.45
Weeks, K., Hancok, N., & Honey, A. (2021). The experience of living after ECT: A qualitative meta-synthesis. Journal of Mental Health, 30, 526-540.
Wisner Baum. (2023). Electroconvulsive Shock ‘Therapy’(ECT) Lawsuit. https://www.wisnerbaum.com/defective-medical-device-injuries/ect
World Psychiatric Association. (2020). Code of ethics for psychiatry. https://www.wpanet.org/_files/ugd/842ec8_1d812c6b8a4f4d24878ee1db8a6376f6.pdf