Unmodified electroconvulsive therapy: the perspective of patients from a developing country.
BACKGROUND
The controversy that exists over the relevance of electroconvulsive therapy (ECT) in contemporary psychiatric care often excludes the opinion of patients. Optimizing ECT service delivery must include the perspectives and input of service users. In Nigeria, the opinions of patients have not been explored.


OBJECTIVE
To evaluate the perspective of patients who have previously received ECT toward the process of delivery and the benefits and adverse effects of unmodified ECT.


METHODS
Ninety consecutive consenting stable outpatients who had received unmodified ECT between 6 and 12 months from the time of study were surveyed in a cross-sectional study design over a 3-month period using a semistructured Likert-type questionnaire at a referral psychiatric hospital in Nigeria.


RESULTS
Most (75.5%) of the patients did not find the procedure stressful and reported ECT being beneficial (82.2%). Most complained of deficiency in the process of ECT service delivery and reported not been adequately informed before receiving ECT (88.9%). A third reported experiencing memory impairment after ECT. Headaches and muscle pains were reported in 8.9% and 17.8% of patients, respectively. Patients who experienced headaches after ECT were more likely to perceive ECT as stressful (P < 0.005), whereas those who experienced memory impairment were less likely to receive ECT again if indicated (P < 0.001).


CONCLUSIONS
Unmodified ECT is fairly well accepted among patients, although a majority complained of deficiencies in information provided about and consent toward the procedure. Improving ECT service delivery and addressing adverse effects may improve treatment acceptability.
James
Bawo O
BO
Department of Clinical Services, Federal Neuropsychiatric Hospital, Uselu, Benin City, Edo State, Nigeria. bawojames@yahoo.com
Morakinyo
Olufemi
O
Lawani
Ambrose O
AO
Omoaregba
Joyce O
JO
Olotu
Osasu S
OS
D001290:Attitude; D003430:Cross-Sectional Studies; D003906:Developing Countries; D004565:Electroconvulsive Therapy; D006261:Headache; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D009549:Nigeria; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome