ECT remains a controversial subject

The controversial topic of electroconvulsive therapy (ECT) is in the news again following the publilcation of a new study by a team of clinicians and scientists from the University of Aberdeen. The researchers looked at how the method acts on the brain and discovered the ways in which different parts of the organ communicate with each other.

Published in the journal Proceedings of the National Academy of Sciences, the report found ECT serves to reduce an overactive connection between the regions of the brain that regulate mood, thought and concentration.

Ian Reid, Professor of Psychiatry at the University of Aberdeen and Consultant Psychiatrist at Royal Cornhill Hospital, said: "For the first time we can point to something that ECT does in the brain that makes sense in the context of what we think is wrong in people who are depressed."

Professor Reid pointed out, however, that the approach is only used on individuals who need treatment quickly - such as those who are severely depressed or even contemplating suicide.

Others, however, remain sceptical about the value of ECT. Consultant clinical psychologist Dr Lucy Johnstone C Psychol, who has published widely on the topic, says:

"I find this very worrying. Connections in the brain are there for a good reason, and there is bound to be an impact on 'normal' functioning as well as on low mood. I am also concerned that the apparent benefits might simply indicate a reduced ability to reflect on and work through the difficult events that are linked with depression. Is this really the best way to intervene?

"The lack of a control group makes this study almost worthless, since similar short term improvements are achieved by placebo or sham ECT. We should not mistake cognitive confusion for a cure."

Lucy Johnstone has misread the paper - if indeed she has read it at all. It makes perfectly clear the significance of "impact on normal function", and explains why the adverse effect of ECT on cognitive function may be inescapable. As for the worth of the study, clearly the reviewers at PNAS don't agree - nor does the media worldwide, apparently. The study was not a trial of ECT efficacy. This sort of polarisation of view is entirely unhelpful, and does not reflect the content and balance of the paper.

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