title: Are patients' attitudes towards and knowledge of electroconvulsive therapy transcultural? A multi-national pilot study.
abstract: BACKGROUND
  Electroconvulsive therapy (ECT) is an effective, yet controversial treatment. Most patients receiving ECT have depression and it is likely that the majority having this treatment are older adults. However, attitudes towards ECT and knowledge of ECT in this population have never been studied in relation to the patients' cultural background.
  
  
  OBJECTIVE
  To compare the attitudes and knowledge of ECT among older adults depressed patients across three culturally different populations and to explore the relationship between culture, knowledge and attitudes.
  
  
  METHODS
  The study was conducted in one centre in each country. A semi-structured survey was used which included three sections: demographics characteristics, attitudes towards and knowledge of ECT.
  
  
  RESULTS
  A total of 75 patients were recruited in this study: 30 patients from England; 30 patients from Argentina; and 15 patients from Canada. There was a significant difference in knowledge about ECT across the three countries. No significant difference was found in terms of attitudes. Knowledge was poor in all three countries. The most influential factor shaping subjects' attitudes and knowledge of ECT differed for the three countries. A weak correlation was found between knowledge of and attitudes towards ECT across all patients from the three different countries.
  
  
  CONCLUSIONS
  Attitudes towards ECT are a very complex phenomenon. We could not find evidence that a particular cultural background affects attitudes towards ECT. Generalising the results of our study is restricted by the fact that this was a pilot study that suffered from limitations including small sample size and number of settings.
authors.affiliation: Old Age Psychiatry, The Royal London and Barts Training Scheme, London, UK. julianbustin@gmail.com
authors.forename: Julian
authors.initials: J
authors.lastname: Bustin
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Rapoport
authors.forename: Murali
authors.initials: M
authors.lastname: Krishna
authors.forename: Daniel
authors.initials: D
authors.lastname: Matusevich
authors.forename: Carlos
authors.initials: C
authors.lastname: Finkelsztein
authors.forename: Sergio
authors.initials: S
authors.lastname: Strejilevich
authors.forename: David
authors.initials: D
authors.lastname: Anderson
mesh_terms: D000328:Adult; D000368:Aged; D003431:Cross-Cultural Comparison; D003866:Depressive Disorder / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects