Electric-shock therapy 'positive'
People who have electric- shock treatment for depression against their will have similar outcomes to those who undergo it voluntarily, according to a major new study by Trinity College.
The research found people who have it involuntarily were more severely unwell before the treatment and more likely to have psychotic symptoms, such as hallucinations and delusions as well as physical deterioration due to severe self-neglect.
However, in both groups, outcomes at the end of therapy were similar, with the majority of people rated "very much improved" or "much improved".
The findings, in the journal 'Brain Stimulation', were based on the largest study of its kind internationally, said Professor of Psychiatry Declan McLoughlin, from Trinity's Department of Psychiatry and Trinity Institute of Neuroscience.
Electric-shock treatment is the most effective acute therapy for severe depression and at times is given against a patient's will, although checks and balances are in place.
Around 50 patients a year receive the treatment involuntarily.
Prof McLoughlin looked at records of five years of involuntary treatment at St Patrick's Mental Health Services, Dublin.
"People who require involuntary electroconvulsive therapy are among the most severely unwell in our mental health services," he said.
"Yet, because they generally lack decision-making capacity and cannot take part in research, we do not know for sure if we can apply research advances to persons having it involuntarily.
"Our knowledge of how best to use it to help someone recover from severe depression is based on research samples comprised entirely of people choosing to have it voluntarily."
The results were reassuring for patients and a relief to mental health professionals, he pointed out.