Academic journal article Indian Journal of Psychiatry

ECT: Knowledge and Attitude among Patients and Their Relatives

Academic journal article Indian Journal of Psychiatry

ECT: Knowledge and Attitude among Patients and Their Relatives

Article excerpt

Byline: B. Chavan, Suresh. Kumar, Priti. Arun, Chander. Bala, Tushar. Singh

Background: It is believed that people lack sound knowledge and appropriate attitude towards electroconvulsive therapy (ECT). However, very little systematic research has gone into this area. Aim: To examine the knowledge and attitude of patients and their relatives towards ECT. Methods: A 16-item questionnaire with satisfactory face validity and content validity was constructed and translated into Hindi. It was then administered to 89 patients and 83 relatives attending the psychiatry services in a major hospital in north India. Results: More than 65% of the respondents in both the groups-patients as well as relatives-gave correct responses such as ECT is life saving, many times it causes temporary but not permanent memory impairment and that ECT is not a non-scientific treatment. There was non-significant disagreement between the two groups. Conclusion: The study is a preliminary exploratory one and is likely to give direction for further research with refined methodology.

Introduction

Despite evidence that electroconvulsive therapy (ECT) is effective[1],[2],[3] and safe[3], and leads to shorter and less costly inpatient treatment,[4] it is rarely used as the first line of treatment and is generally reserved for older and resistant cases of depression and other psychiatric disorders. Certain factors such as social stigma, inadequate undergraduate training, doubts about its efficacy and safety, ambivalence among psychiatrists and doubts about its being a cost-effective alternative to antidepressant treatment, might have limited the use of ECT in the management of depression. It has been reported that the use of ECT is not uniform throughout the United States. While examining various reasons of limited use of ECT, Salzman has commented that ECT failed to attract scientists to carry out research on ECT as compared to antidepressant treatment. Much of the content in this paragraph is USA-sensitive.

Numerous studies have addressed the issue of knowledge and attitude towards ECT not only among the patients[6],[7],[8],[9],[10] and their relatives[8] but also among the lay public[12], among adolescent patients and their parents,[13],[14] and also among health professionals including psychiatrists.[1],[15] Although no standard procedure for attitude assessment exists, most of these studies have utilized a questionnaire framed from the experience of clinicians. Concerns were frequently expressed, probably because ECT was not fully understood by the patients and their families.[13] The authors of this study, too, noted from their clinical experience that patients and their relatives had many misconceptions as well as a negative attitude towards the use of ECT. Previous studies had taken up only those patients who had completed a course of ECT in past.[6],[7],[10] A notable difference between the findings of western and Indian studies is that knowledge is quite satisfactory and the attitude is positive in Indian subjects.[10],[15],[18] The present study was carried out to examine the knowledge and attitude towards ECT among patients and relatives attending the psychiatric services in a major hospital in north India.

Methods

The study was conducted at the Department of Psychiatry, Government Medical College, Chandigarh with the aim to study with the help of a questionnaire the knowledge and attitude of patients and their relatives towards ECT. The study was undertaken with the following objectives:

Objectives

*Construction of a questionnaire *Assessment of attitude and knowledge of stable psychiatric patients *Assessment of attitude and knowledge of healthy relatives of psychiatric patients *Comparison of responses between relatives and patients The study was conducted in two phases

Phase 1: Framing of the questionnaire-The items for the questionnaire were drawn from two sources:

*Published questionnaires and scales that assess attitudes of diverse populations towards ECT. …

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