The sham ECT literatures: Implications for consent to ECT

Colin A. Ross Institute for Psychological Trauma, 1701 Gateway, Suite 349, Richardson, TX 75080, USA.
Ethical human psychology and psychiatry 02/2006; 8(1):17-28. DOI: 10.1891/ehpp.8.1.17
Source: PubMed


The author reviewed the placebo-controlled literature on electroconvulsive therapy (ECT) for depression. No study demonstrated a significant difference between real and placebo (sham) ECT at 1 month posttreatment. Many studies failed to find a difference between real and sham ECT even during the period of treatment. Claims in textbooks and review articles that ECT is effective are not consistent with the published data. A large, properly designed study of real versus sham ECT should be undertaken. In the absence of such a study, consent forms for ECT should include statements that there is no controlled evidence demonstrating any benefit from ECT at 1 month posttreatment. Consent forms should also state that real ECT is only marginally more effective than placebo.

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    • "The temporary resultant euphoria or, more commonly, the resultant apathy and indifference, are considered an improvement and resemble a 'taming effect' (Abrams and Taylor, 1983) which are uncritically treated as markers of success (see also Burstow, 2006; 2012). With so little known about the formation and process of children's physically developing brains (Baker, 1996), purposely inducing damage through a scientifically unfounded procedure (Enns and others, 2009; Ross, 2006) arguably represents unacceptable high risk experimentation on children. "
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    ABSTRACT: This article examines the controversial and largely publicly undocumented practice of administering electroconvulsive therapy (ECT or electroshock) to children who are undergoing psychiatric treatment. Conventional psychiatric beliefs and practices are challenged, along with a presentation of the history of scientific research which questions electroshock's ‘effectiveness’ and outlines its brain-damaging and incapacitating effects. As such, we provide counterarguments regarding the legitimacy of ECT as a treatment option, deconstructing the principle of presumed prudence in its use. Our analysis leads us to conclude that the ‘principle of presumed prudence’ should be eschewed in favour of the ‘precautionary principle’, in order to underscore and uphold the medical ethos ‘to do no harm’ and to ensure the application of children's rights within the psychiatric system.
    Full-text · Article · May 2014 · Children & Society
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    • "Moreover, meta-analyses of antidepressant treatment trials show benefits that are statistically significant but of marginal clinical significance [21]. Even concerning the ''most invasive'' treatment of depression, electroconvulsive therapy, several authors claim that there is no study demonstrating a significant difference between real and sham therapy at 1 month post-treatment [22]. "
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    ABSTRACT: Introduction: Animal-assisted therapies involve interaction between patients and an animal with the aim of improving mental wellbeing and diminishing anxiety and agitation in patients. To date, few pilot studies focusing on animal-assisted therapeutic effects have met minimal standards of research design and have included standardized outcome variables or physiological measures, depicting the need for scientific research on animal-assisted therapy. Methods: In this pre- and post-treatment controlled crossover study we measured state anxiety with the State-Trait Anxiety Inventory (STAI), a brief, easy-to-administer self-report measure that is widely used in research and clinical practice. Twelve acutely depressed patients (six male; age: 40.5±10 years) participated after giving written informed consent in accordance with the Declaration of Helsinki after the study had been explained in detail. Results: The STAI state score was significantly reduced after the presence of a dog (47.0±11 versus 42.2±10) (Z=-2.402; p=0.016) which was not the case after the control condition without the presence of a dog (50.41±10 versus 48.0±9) (Z=-0.981; p=0.327). Conclusion: This finding suggests that animal-assisted therapy causes highly significant reductions of state anxiety. Presence of dogs may offer an additional therapeutic benefit that might decrease anxiety and enhance psychotherapeutic strategies and motivation of patients and therapists.
    Full-text · Article · Oct 2009 · European Journal of Integrative Medicine
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