The self-reported positive and negative effects of electroconvulsive therapy: an international survey

• In an online survey 766 ECT recipients, from 41 countries, provided up to three positive and three negative outcomes. • 51 % reported only negative effects, 46 % reported a mixture of positive and negative effects and 3 % reported only positive outcomes. • The most reported positive effects were: ‘Improved Mood’ (23 %) and ‘Reduced Suicidality’ (13 %). • The most reported negative effects included: ‘Memory Loss’ (82 %), ‘Cognitive Decline’ (29 %), ‘Abused/Violated/Traumatised’ (8 %), and ‘Impaired Relationships’ (5 %). • Continued usage of ECT is dependent on future research into adverse effects besides memory loss. When assessing the efficacy and safety of any medical procedure the experiences of patients need to be considered. This paper adds to the growing body of studies asking recipients of electroconvulsive therapy about their treatment experiences. Open questions about the positive and negative effects of ECT, in an online international survey, were responded to by 776 ECT recipients, from 41 countries. About half (48.8 %) spontaneously reported one or more positive effects and almost all (96.9 %) spontaneously reported one or more negative effects. About half (51.2 %) reported only negative effects, 45.6 % reported a mixture of positive and negative effects and 3.2 % reported only positive outcomes. Content analysis found that the most reported positive effects were: ‘Improved Mood’ (23.2 %), ‘Reduced Suicidality’ (12.6 %) and ‘Reduced Psychosis’ (3.1 %). The most reported negative effects were: ‘Memory Loss’ (81.6 %), ‘Cognitive Decline’ (29.0 %), ‘Headache’ (11.1 %), ‘Abused/Violated/Traumatised’ (7.9 %), ‘Fear/Anxiety’ (6.8 %), ‘Impaired Relationships’ (5.4 %), ‘Brain Damage’ (5.0 %), ‘Can’t Work’ (4.9 %) and ‘Pain’ (4.9 %). This convenience sample may have been biased towards those with negative or positive attitudes about ECT. Some of the negative and positive effects attributed to ECT may have been the result of other factors (such as illness and age, or placebo, respectively). These results, in conjunction with previous studies, suggest the need for new, more robust, independent research into safety and efficacy. The safety component of such studies should probably include adverse effects beyond memory loss and cognitive decline.