Electroconvulsive therapy

Electroconvulsive therapy is one of the most controversial treatments in medicine. Opinions are often polarised; some consider electroconvulsive therapy to be effective and potentially lifesaving whereas others regard it as unhelpful and harmful and campaign energetically for it to be banned. In response to comments on a mental health white paper, “Reforming the Mental Health Act,” the UK Department of Health commissioned two systematic reviews of electroconvulsive therapy in 2001. One assessed its efficacy and safety in the treatment of depression,1 mania, and schizophrenia and the other reviewed surveys of patients' experiences and is published in this issue of the BMJ (p 1363).2

So what is the current status of our knowledge about electroconvulsive therapy? Both reviews reveal the limitations of the primary studies and the need for genuinely collaborative high quality research-rather than research done by consumers for consumers and by clinicians for clinicians resulting in research with limited general credibility. Nonetheless both reviews produced some useful results. The systematic review …