The patient perspective of the consent process and side effects of electroconvulsive therapy

Abstract

Background: Electroconvulsive therapy (ECT) is an effective yet controversial treatment. It is thus important to explore patients' experiences of ECT.

Aims: To assess patients' experience of ECT, focusing on the consent process and treatment side effects.

Method: Three-hundred-and-eighty-nine patients completed a questionnaire about their experience of ECT as part of a quality assurance programme. Quantitative and qualitative data were obtained

Results: Almost half the patients reported memory loss after ECT. Overall the consent process was reported as having been adequate, with a possible exception in the provision of written information and discussion about alternatives to ECT and the consequences of not having it. Seventy-two percent of those patients who commented on whether ECT worked, said the treatment improved their condition.

Conclusions: Psychiatrists need to improve the informed consent process. Subjective memory loss is very common and persistent memory complaints occurred in a minority. Memory should therefore be closely monitored before, during and after a course of ECT.

Keywords:

• Electroconvulsive Therapy (ECT)
• patient views
• consent
• side effects
• memory

Acknowledgements

We thank all ECTAS member clinics, and all those who returned questionnaires.

LR and KK contributed equally to this paper.

Declaration of interest: All the authors work with the ECT Accreditation Service at the Royal College of Psychiatrists' Centre for Quality Improvement.