ECT Increases Readmission

Kermit Cole
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ECT-treated patients were at a greater risk of readmission compared to non-ECT treated patients, according to a study published online May 25, 2012 in the Journal of ECT. The study found that adjusting for planned readmissions masks the increased negative outcome associated with ECT.

Abstract → 

Byrne, S. Hooke, G. et. al; “Readmission to psychiatric hospital after treatment for depression with electroconvulsive therapy: the effect of planned readmissions” Journal of ECT, vol. 28(2) e12-3; published online May 25, 2012

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

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Kermit Cole
Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected]

6 COMMENTS

  3. What interested me is, if you read the abstract, they actually say “not accounting for planned readmissions may lead to overestimations of negative outcomes.”
    It’s plausible to think that, given the clear belief of the researchers that ECT is effective, the “planned” nature of readmission might obscure its effectiveness. It takes a step back from that to ask why readmissions for a supposedly effective treatment are so predictable as to be planned. Within the context of severe depression and the concern of all involved it’s easy to see it as being an understandable mistake. Not an innocuous one, but explicable.
    What I appreciate is that they did publish it, and in the Journal of ECT, where we can find it and ask the question in a public way; does this make sense?
    Some of the news lately has been about the bias toward publishing positive results. Part of that is to take results that might be seen as negative and interpret them as positive. I believe this can happen innocently, as I believe it happened here; looked at through a certain lens, it all makes sense.
    But we can also see it as a negative result, and I’m glad we have the chance to.

  5. Whenever conclusions around benefit or value of *treatment* are drawn from objective data, by the authors of any research article, we are viewing the value judgements of the authors. There is no way , in this case, to determine what an individual patient’s view of readmission, planned or not means to them in terms of receiving benefit of ECT, or in terms of the need hospitalization during an episode of depression. the decisions in both cases are made by their psychiatrists.

    A more informative article might look like this: “Psychiatrisits are more likely to hospitalize patients whose health insurance provider will certify inpatient/acute care.”

    Could it be that a patient receiving ECT is in a *higher risk* category- easier to certify for acute care? or automatically approved by health insurance providers?

    I doubt there is any measurement that can be standardized to prove or disprove benefit of any psychiatric *treatment*. Subjective testimony is the only valid proof of outcome when it comes to matters of the mind, soul and spirit of a human being.

  6. I believe that planned readmission refers to people scheduling future ECT at a hospital. I believe that regardless of how macabre ECT appears to be, some people who CHOOSE this procedure find that it promotes a TEMPORARY improvement in mental disposition (albeit dazed and confused). Since it does nothing to solve REAL problems that cause mental distress, one round of electric jolts is hardly effective. Since the study was published by the Journal of ECT, I assume that the results of their study are skewed in their favor. I accept that the readmission for their patients is similar to the readmission for patients of drug therapies (that dominate the industry) because of the poor outcomes for drug therapies. I also assume that the readmission rate for patients who receive ongoing talk therapy is the lowest.

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