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Objective: This study sought to compare pre-intervention patient characteristics and post-intervention outcomes in a naturalistic sample of adolescent inpatients with treatment-resistant psychotic symptoms who received either electroconvulsive therapy (ECT) or clozapine., Methods: Data of adolescents with schizophrenia/schizoaffective disorder receiving ECT or clozapine were retrospectively collected from two tertiary-care psychiatry-teaching university hospitals. Subscale scores of the Positive and Negative Symptom Scale (PANSS) factors were calculated according to the five-factor solution. Baseline demographics, illness characteristics, and post-intervention outcomes were compared., Results: There was no significant difference between patients receiving ECT ( n  = 13) and clozapine ( n  = 66) in terms of age, sex, and the duration of hospital stay. The ECT group more commonly had higher overall illness and aggression severity. Smoking was less frequent in the clozapine group. Baseline resistance/excitement symptom severity was significantly higher in the ECT group, while positive, negative, affect, disorganisation, and total symptom scores were not. Both interventions provided a significant reduction in PANSS scores with large effect sizes., Conclusion: Both ECT and clozapine yielded high effectiveness rates in adolescents with treatment-resistant schizophrenia/schizoaffective disorder. Youth receiving ECT were generally more activated than those who received clozapine.

Background: Subjective memory deficits are common in depression and during series of treatment with electroconvulsive therapy (ECT). There is a need for feasible assessment of memory deficit. In the Swedish National Quality Register for ECT, patients' subjective memory function is rated by a clinician. Self-ratings would be easier to administer. Objectives: The aim of this study was to analyze the consistency between self-reported and physician estimated subjective memory in depressed patients treated with ECT. Methods: Fifty-two inpatients treated with ECT for major- or bipolar depression were recruited and 41 of them completed the study protocol. Each patient rated their own subjective memory and had it rated in an interview by a physician both before/in the beginning of the ECT series and after the ECT series. The patients' memory was rated and self-rated with the memory item in the Comprehensive Psychopathological Rating Scale (CPRS). We then analyzed correlations, and differences in distributions, between self-reported assessment and physician estimates of patients' subjective memory. Results: The correlations between the self-reported and the physician estimated ratings of subjective memory were 0.699 ( p  < .01) in baseline ratings and 0.651 ( p  < .01) in post-treatment ratings. These correlations were relatively high compared to a previous study on self-reported vs. physician estimated CPRS ratings. Conclusions: Based on the results in this study, we propose that patients' self-ratings of subjective memory in association with ECT can be used instead of a physician's rating of patients' subjective memory.

Objectives: Electroconvulsive therapy (ECT) is the most effective therapy for severe depressive and psychotic disorders. As patients may be subject to legal incapacity and lack of insight, treatment may be administered against the patient's will. There is only limited evidence on the use of ECT against the patient's non-autonomous will., Methods: We report a series of eight patients who received ECT against their will in two German university medical hospitals between 2014 and 2016. The effectiveness, tolerability and patients' perspective are described., Results: Seven of eight patients were much or very much improved according to the Clinical Global Impression Scale. Capacity to consent was restored in seven patients. Transient side effects occurred in four patients. Seven patients agreed to receive further ECT in the treatment course., Conclusions: This case series suggests that ECT may (and sometimes should) be administered to severely ill, non-consenting patients against their will with good effectiveness. Potential and mostly moderate and transient side effects have to be weighed up against the potentially life-saving character of ECT in patients with, e.g., suicidality and food refusal. Most importantly, the patients' retrospective appraisal also justifies the administration of ECT in situations of severe mental illness and legal incapacity.

Background: A discrepancy exists between clinician-led studies of people's experience of electroconvulsive therapy (ECT) and consumer-led studies, with the former typically being much more positive about the efficacy and side effects of ECT compared with the latter. Qualitative in-depth explorations of people's experiences of ECT are relatively rare, particularly those looking specifically at women's experience of ECT., Aims: The aim of this qualitative study was to explore women's experiences of ECT, particularly their experience of knowledge and power related to ECT., Results: Qualitative analysis of the interviews with nine women resulted in four main themes emerging from the interviews with the women: (i) "he really didn't say much," (ii) "I'm going to be very upset with you," (iii) "I was just desperate," and (iv) "it was like we were cattle.", Conclusions: Overall, participants found their experiences with ECT to be quite negative, and characterized by a lack of knowledge during the procedure, and a lack of power throughout the entire process.

Background: Aside from the focus on satisfaction levels, psychological aspects of the experience of electroconvulsive therapy (ECT) have not traditionally been the focus of significant research. Given that clinical psychologists work closely with professionals involved in administering ECT, and have increasing involvement with decisions about ECT, there is a potential role for clinical psychologists in this area., Aims: To review the diverse sources of literature regarding how patients psychologically experience, and react to, ECT., Method: A literature search identified relevant published papers related to the patient experience of ECT. Reviewed articles included clinician and service user led research, comprising qualitative and quantitative research approaches and policy documents., Results: Patients have multiple and diverse reactions to ECT. These can be considered under the themes of consent, fear, powerlessness, memory and identity. The experience of ECT can significantly impact on patients and this can have a negative long-term influence., Conclusions: Clinical psychologists need to be actively involved in consent procedures, use clinical formulation to understand the perspective of patients, and empower patients to share their views of ECT with mental health professionals and service developers. Further research into how patients experience ECT, particularly using qualitative methods, is recommended.

Background: The concept of valid consent has become important for electroconvulsive therapy (ECT). However, many patients feel that they do not have enough information before consenting and a significant minority feel coerced into consenting. Little is known about what factors account for these views., Aim: To explore patients' perceptions about how they consented to ECT., Method: Twelve participants were interviewed about their experiences of consenting to ECT. Interviews were subjected to a thematic analysis., Results: Participants' perceptions of consenting to ECT were complex, and interpersonal factors were found to be important. Many participants felt that they had consented without adequate information from medical sources and that they had little choice to agree. Two participants consented to ECT as either a form of self-harm or hoping it would kill them., Conclusion: Consenting to ECT is more complex than currently recognised and involves interpersonal and systemic factors. As a result, people may consent because they feel that they have little choice. Implications for practice are discussed.

This article presents findings and analysis stemming from a two-year qualitative study that explored, in their own voices, women's lived experience of electroshock. Feminist standpoint theory frames and provides the moorings for both the validity and methodology of this woman-centered inquiry. In addition, nurses' experiences with and views of ECT are explored and compared to the experiences reported by the women recipients themselves. Vulnerability and disconnection as emergent themes are presented for the nursing profession's sober consideration. The nurses interviewed believed electroshock culminated in a net gain for patients, but for the majority of the women interviewed, electroshock resulted in damage and devastating loss. This article closes with pressing questions for nurses to ask ourselves as we enter the second decade of this new and promising millennium.

We used before-and-after testing with the Rorschach Inkblot Test (Exner, 1997/2003) and the Minnesota Multiphasic Personality Inventory-2 (Butcher et al., 2001) to assist a psychotherapy client--a survivor of child abuse suffering from depression accompanied by hallucinations--in evaluating a course of electroconvulsive therapy that she underwent. The results of both tests indicated positive changes. During the collaborative discussion of the test results, especially the changes seen on the Rorschach, a deeper understanding of her skeptical response to evidence of improvement came to light and helped to refocus the ongoing psychotherapy work.

Objectives: Despite its proven efficacy and safety, electroconvulsive therapy (ECT) has a negative image and attracts widespread public criticism. In contrast, perceptions of patients who have received ECT appear to be more favourable. This review intended to encapsulate the evidence on knowledge and views concerning ECT among its recipients., Methods: Extensive electronic and manual searches were conducted to identify all relevant studies on the subject., Results: Seventy-five reports were found suitable. The evidence from these studies suggested that patients undergoing ECT were usually poorly informed about it. This was attributable to factors such as unsatisfactory pre-treatment explanations or post-ECT memory impairment. About one-third undergoing ECT reported feeling coerced to have the treatment. Fear of ECT and distressing side effects were also present in a majority. Despite these problems, a vast majority of patients perceived ECT to be helpful and had positive views regarding the treatment. Simultaneously, a sizeable proportion was quite critical, although little was known about the extent and nature of such disapproval., Conclusions: Overall, the weight of the evidence supports the notion that patients undergoing ECT are well-disposed towards it. However, much needs to be done to improve the practice of ECT and to enhance patients' satisfaction with the experience of treatment.

The perceptions of patients and their family members about electroconvulsive therapy (ECT) are crucial to understanding the meaning attached to having ECT and the impact it has on quality of life. Thus, in this qualitative study, patients and their family members described their perceptions of having electroconvulsive therapy (ECT). The experience occurred in two distinct periods in the patient's life: making the decision to have ECT and the physical and emotional aftermath of treatment. One of the most important themes in the study was a need for patients and families to be better informed about the risks of ECT.