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The effectiveness of electroconvulsive therapy: A literature review

Published online by Cambridge University Press:  11 April 2011

John Read  and
Richard Bentall
John Read*
Affiliation:
Department of Psychology, University of Auckland (New Zeland)
Richard Bentall
Affiliation:
Department of Psychology, Bangor University, Wales (United Kingdom)
*
Address for correspondence: Professor J. Read, Department of Psychology, University of Auckland, Room: 721.305, Tamaki Campus, Auckland 1142, (New Zealand). E-mail: [email protected]
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Summary

Aim – To review the literature on the efficacy of electroconvulsive therapy [ECT], with a particular focus on depression, its primary target group. Methods – PsycINFO, Medline, previous reviews and meta-analyses were searched in an attempt to identify all studies comparing ECT with simulated-ECT [SECT]. Results – These placebo controlled studies show minimal support for effectiveness with either depression or ‘schizophrenia’ during the course of treatment (i.e. only for some patients, on some measures, sometimes perceived only by psychiatrists but not by other raters), and no evidence, for either diagnostic group, of any benefits beyond the treatment period. There are no placebo-controlled studies evaluating the hypothesis that ECT prevents suicide, and no robust evidence from other kinds of studies to support the hypothesis. Conclusions – Given the strong evidence (summarised here) of persistent and, for some, permanent brain dysfunction, primarily evidenced in the form of retrograde and anterograde amnesia, and the evidence of a slight but significant increased risk of death, the cost-benefit analysis for ECT is so poor that its use cannot be scientifically justified.

Declaration of Interest: Neither author has any financial conflicts of interest in relation to this paper.

Keywords

ECTevidence-based medicineliterature reviewcost-benefit analysis
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 19 , Issue 4 , December 2010 , pp. 333 - 347
Copyright
Copyright © Cambridge University Press 2010

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