How open questions reveal the full extent of damage done by electroconvulsive therapy

Credit: RDNE Stock project from Pexels

An international study, the first of its kind to use an online survey to capture the long-term effects of Electroconvulsive Therapy (ECT) on patients, has revealed that while some patients experience improved mood, an overwhelming majority reported significant and often permanent cognitive damage, including memory loss (82%).

Open questions can be more revealing than asking people to respond yes or no to lists of effects predetermined by researchers: in this study, besides memory loss, participants reported feeling “violated” (8%) and suffering from “cognitive decline” (29%).

The research, led by Professor John Read at the Department of Psychology & Human Development at the University of East London, gathered data from 776 recipients across 41 countries, with 51% of respondents reporting only negative effects from the procedure, while just 3% reported only positive outcomes.

Although the study acknowledges that ECT is perceived by some as a life-saving intervention, with 13% of respondents crediting the treatment with reducing suicidality, and 23% reporting a positive impact on their depression, many reported negative social impacts: with 33% reporting that they lost their jobs and 68% developing relationship issues due to ECT.

The research team of six includes three people who have received ECT themselves, and three Clinical Psychologists. The paper concludes, “When assessing the efficacy and safety of any medical procedure, the experiences of patients need to be considered. … This large international group of ECT recipients, taken together with previous studies of patient accounts, points to the need for further research designed to better delineate the benefit/risk ratio of ECT. The safety component of such studies should, perhaps, include the adverse effects reported by our participants.”

Lead author, Dr. John Read, Professor of Clinical Psychology at the University of East London, commented, “This overwhelmingly negative appraisal of ECT, by the largest international sample of patients to date, suggests that psychiatrists are misleading patients and relatives when they tell them it is safe and effective.

“The memory loss caused by ECT is well documented but is usually estimated as far less than our 82% finding when asking patients directly. The traumatizing effects of the whole process, and the negative effects of ECT on relationships and work have not been properly researched before.”

Co-author, Lisa Morrison, an ECT recipient, commented, “Patients harmed by ECT have been ignored and silenced for decades. There is no monitoring of the effects beyond the end of treatment nor access to rehabilitation for debilitating and permanent life-altering consequences. Why are psychiatrists with the power and influence to change this, ignoring or undermining those of us harmed? Why do public regulatory bodies allow this to continue? These are human rights failings in plain sight.”

Sue Cunliffe, another co-author, was a doctor until ECT made it impossible for her to continue working. She adds, “This research acknowledges the lived reality of ECT patients by giving a voice to both the positive and negative experiences of patients. ECT psychiatrists repeatedly state that ECT cannot cause brain damage. But I was diagnosed by a neuropsychologist as having ECT brain injury.”

Rosie Weatherley, Information Content Manager at Mind commented, “Mind echoes concerns raised by this research. The evidence base for ECT has never been fit for purpose and this latest study further substantiates the need for a re-think about whether and when this treatment is offered to patients.

“We support calls for more research on ECT, and welcome further scrutiny to ensure only helpful, evidence-based treatments continue to have a place in our health care system. There are many effective treatments for mental health problems that do not share this risk profile.”

The study is published in the Journal of Affective Disorders Reports.

Electroconvulsive therapy linked to wide range of severe effects, international survey suggests