ECT has been controversial since its invention 70 years ago, indeed still remains the most controversial practice within conventional psychiatry, and I'm assuming this is the reason Baboon2004 posted on the topic here: because of the inherent and continuing ambiguity and skepticism concerning the nature and the effectiveness of the practice (Of course, many other areas of somatic and clinical psychiatric practice are also controversial, including in fact, its entire - dubious - methodology [ of simply treating symptoms - inconsistently applying somatic 'solutions' to behavioural and social problems - and invariably ignoring the underlying causes of mental distress]. For example, psychologist John Breeding maintains that so-called psychiatric illness is the product of unresolved psychic conflict, further delineating (in "
The Necessity of Madness: Explaining How Psychiatry Is a Clinical Construct and Madness Is a Metaphor") what he regards as the psychological effects of ECT, particularly:
1) Suppression of emerging distress material
2) Suppression of ability to heal by emotional release;
3) Creation of emotional distress, including deep feelings of terror and powerlessness;
4) Promotion of human beings in the roles of victims and passive dependents of medical professionals;
5) Confirmation of patients' belief that there is something really wrong with them (shame).
And the very latest research on the adverse effects of ECT further confirm long-standing suspicions. Dr. Harold A. Sackeim, an American psychologist and former proponent of ECT, chief of the department of biological psychiatry at New York State Psychiatric Institute and professor of clinical psychology at Columbia University, and co-author of more than 200 publications relating to ECT, has recently reversed radically his position on such therapy by publishing, in the
Nature journal, earlier this year
study results in Neuropsychopharmacology which followed 250 ECT patients in New York City hospitals. The study found that bilateral ECT (the most commonly used) does indeed cause permanent amnesia, as patients have long claimed, and results in mental impairment, especially among women and elderly patients. Here's the Abstract summarizing the findings of that study:
Despite ongoing controversy, there has never been a large-scale, prospective study of the cognitive effects of electroconvulsive therapy (ECT). We conducted a prospective, naturalistic, longitudinal study of clinical and cognitive outcomes in patients with major depression treated at seven facilities in the New York City metropolitan area. Of 751 patients referred for ECT with a provisional diagnosis of a depressive disorder, 347 patients were eligible and participated in at least one post-ECT outcome evaluation. The primary outcome measures, Modified Mini-Mental State exam scores, delayed recall scores from the Buschke Selective Reminding Test, and retrograde amnesia scores from the Columbia University Autobiographical Memory Interview–SF (AMI–SF), were evaluated shortly following the ECT course and 6 months later. A substantial number of secondary cognitive measures were also administered. The seven sites differed significantly in cognitive outcomes both immediately and 6 months following ECT, even when controlling for patient characteristics. Electrical waveform and electrode placement had marked cognitive effects. Sine wave stimulation resulted in pronounced slowing of reaction time, both immediately and 6 months following ECT. Bilateral (BL) ECT resulted in more severe and persisting retrograde amnesia than right unilateral ECT. Advancing age, lower premorbid intellectual function, and female gender were associated with greater cognitive deficits. Thus, adverse cognitive effects were detected 6 months following the acute treatment course. Cognitive outcomes varied across treatment facilities and differences in ECT technique largely accounted for these differences. Sine wave stimulation and BL electrode placement resulted in more severe and persistent deficits.
From
The Cognitive Effects of Electroconvulsive Therapy in Community Settings. Harold A Sackeim, Joan Prudic, Rice Fuller, John Keilp, Philip W Lavori, and Mark Olfson.
What's totally surprising - actually shocking [pun intended] - is that the above study provides the first comprehensive evidence based on a large and statistically significant prospective sample of ECT 'patients' that adverse cognitive effects are evident and furthermore can persist for an extended period, and that they fundamentally characterize routine treatment with ECT in institutionalized community settings.
Sufi said:
... my experience of visiting units all over london is that they are usually over 90% minority people, the vast majority black males.
Yes, and what is startling is that the received psychiatric wisdom - and imagined practice - is that ECT is primarily performed on 'wealthy' patients and rarely on members of ethnic minorities or the economically impoverished. For instance, the
Wiki entry on ECT [an incoherent mess] states that "
About seventy percent of ECT patients are women. This is largely, but not entirely, due to the fact that women are more likely to receive treatment for depression. Older and more affluent patients are also more likely to receive ECT. The use of ECT treatment is "markedly reduced for ethnic minorities."" So yes, racism, sexism, and classism are alive and well within the psychiatric profession.