Electroconvulsive therapy in New Zealand: terrifying or electrifying?
Electroconvulsive therapy (ECT) is viewed by many patients as a 'terrifying' treatment. A petition to ban ECT presented to the House of Representatives in 1999 resulted in the commissioning of a comprehensive review of efficacy and safety of the treatment in New Zealand as well as a requirement for the Ministry of Health (MOH) to collect annual statistics on ECT use. Although the systematic review found that ECT was a safe and effective treatment for depression and some other serious mental illnesses, it still attracted adverse comments from opponents. Almost immediately following its publication, another petition was presented to Parliament, this time requesting that ECT be banned for young people, pregnant women, and older people. Compared to similar countries, New Zealand has a low rate of use for ECT overall, with wide regional variance. There are many misconceptions about ECT in New Zealand that are not in keeping with current standards of practice and may be limiting its use in some areas. However, access to resources for the treatment of depression may be a major limiting factor. 'Electrifying' new research emanating from neurobiological and magnetic resonance imaging (MRI) studies is challenging traditional notions of depression, and is providing more explanations on how ECT and other antidepressant treatments might work. These new findings demonstrate that cognitive deficits and structural brain changes play important roles in serious depression and suggest that early and adequate treatment of major depression should be paramount.
Melding
Pamela
P
Mental Health Services, Waitemata District Health Board, Takapuna, Auckland 1309. p.melding@auckland.ac.nz
D003295:Convulsive Therapy / Q000331:legislation & jurisprudence*; D003863:Depression / Q000150:complications / Q000628:therapy*; D034462:Dissent and Disputes; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D005069:Evaluation Studies as Topic; D019317:Evidence-Based Medicine / Q000379:methods; D006291:Health Policy; D006801:Humans; D007258:Informed Consent; D008569:Memory Disorders / Q000209:etiology; D016743:Mental Competency; D009520:New Zealand; D011639:Public Opinion; D016896:Treatment Outcome