The effect of electroconvulsive therapy on patients' attitude to treatment of depression

The study focuses on how depressed patients who have received either electroconvulsive therapy (ECT) with or without medication or medication only experienced their treatment, and what their subsequent attitude to different treatment modalities was. The study was a joint study between six psychiatric departments. All patients with a diagnosis of major depression hospitalized for at least 48 h during 1990 or 1991 were included. A questionnaire comprising nine questions was mailed to all patients; eight questions dealt with the patients' satisfaction with their treatment and one was about future treatment preference (ECT versus medication). The questionnaires were mailed to 654 patients; 359 (54.9%) returned it. Of these, 113 had received ECT, whereas 246 had not. There were no differences in satisfaction between patients who had received ECT and those who had not. There was a significant difference between the two groups with regard to treatment preference in case of a new depressive episode (P < 0.001); in the ECT group 29.2% preferred ECT in the future if they should become ill again, whereas only 3.7% among patients who had not received ECT did so. Future treatment preference was associated with degree of satisfaction viith previous treatment in both groups. It is concluded that patients receiving ECT are just as satisfied with their treatment as those treated exclusively with pharmacotherapy. ECT-treated patients are more likely to prefer ECT in case of future illness, especially ECT patients with a high degree of satisfaction.