Electroconvulsive Therapy as Viewed by German Psychiatrists

Abstract

OBJECTIVES: Electroconvulsive therapy (ECT) is a stigmatized treatment even among doctors. This restrains the accessibility of ECT for patients in need of this treatment. In Germany, the utilization of ECT is low as compared with other Western industrialized countries. However, increasing application rates of ECT in Germany indicate some degree of support from psychiatrists. Therefore, the present study examined the current attitudes among 3 subgroups of psychiatrists toward ECT. METHODS: A questionnaire was sent through e-mail to 423 psychiatric hospitals in the Federal Republic of Germany and through facsimile to 2550 specialists working in private practice. One hundred eighty-three (43%) of the institutions applied ECT (ECT facilities) and 240 (57%) institutions did not apply (non-ECT facilities). RESULTS: Nine hundred eighty-three answers could be evaluated. One hundred fifteen (63%) of the 183 ECT facilities, 118 (49%) of the 240 non-ECT facilities, and 751 (30%) of the 2500 specialists working in private practice responded. The general attitude toward ECT was favorable: most of the participants agreed that ECT is used less often than it should be to best serve patients' interests (61%-89%) and that it should be applied more often (54%-79%). Most of the participants thought that the image of ECT has improved among psychiatrists (61%-74%) but has not changed among fellow physicians, patients, and the general population. CONCLUSIONS: A surprisingly positive attitude toward ECT was found in our study among all 3 groups of German psychiatrists, which might further help improve patients' access to this treatment.