Read Rebuts Biased ECT Defenders

The Lancet Psychiatry publishes a back and forth between critics and defenders of ECT.

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In 2021, researchers led by John Read published a study finding that ECT clinics in the UK failed to report their outcomes and operated without any oversight. More than a third of patients were given ECT against their will.

In response, a short commentary in Lancet Psychiatry argued it was “time to acknowledge good electroconvulsive therapy research” and accused Read et al. of being biased against the procedure and creating stigma. They called ECT “the most effective of psychiatric treatments.” That paper was written by Tania Gergel, Robert Howard, Rebecca Lawrence, and Trudi Seneviratne. (Notably, according to Read, Robert Howard is a consultant for one of the ECT clinics mentioned in Read’s earlier paper.)

Now, Read, along with Christopher Harrop and Jim Geekie, have penned a response published in Lancet Psychiatry. It’s titled “Time to acknowledge the bias of some electroconvulsive researchers and defenders.”

About Gergel’s claim that ECT is “the most effective of psychiatric treatments,” Read writes:

“In the absence of a single study, after 80 years, showing superiority to placebo beyond the end of treatment… If their claim were true, what would that say about psychiatry’s other treatments?”

Read notes that the last time ECT was compared to a placebo treatment was 1985. Since then, all studies of the treatment have been unable to control for the placebo effect and other confounding factors.

In another study, Read and other researchers—including renowned Harvard researcher Irving Kirsch—concluded that “there is no evidence that ECT is effective for its target demographic—older women, or its target diagnostic group—severely depressed people, or for suicidal people, people who have unsuccessfully tried other treatments first, involuntary patients, or adolescents.”

They wrote that ECT “should be immediately suspended until a series of well designed, randomized, placebo-controlled studies have investigated whether there really are any significant benefits against which the proven significant risks can be weighed.”

They argued that ECT needed to be tested using the gold standard of medical studies, the randomized, controlled trial.

Yet, Read writes, Gergel misstated that conclusion and accused Read and his co-authors of adding to the stigma around ECT.

Read writes that Gergel’s evidence for ECT’s safety is misleading. The study Gergel cites—a large observational study with over 100,000 participants—actually found that 1 in 39 patients experienced cardiac problems after ECT.

Gergel refers to this as evidence of the procedure’s safety, pulling half a quote from the study: “Major adverse cardiac events after electroconvulsive therapy are infrequent” while leaving out the actual numbers.

Moreover, Read writes, “We are equally concerned about the persistent memory loss reported by between 12% and 55% of recipients, which is inadequately monitored by many electroconvulsive therapy clinics.”

Gergel doesn’t mention that finding.

The other study quoted by Gergel as evidence of the procedure’s safety is a study (which, again, was not a randomized, controlled trial) that found no difference in hospitalizations and non-suicide deaths between ECT and those receiving other treatments. That study also found a slight reduction in suicide deaths for those who received ECT—0.1% instead of 0.2%.

However, Read notes that other studies have found the opposite effect and that the evidence base is marred by extremely old studies, biases in reporting and methodology, and lack of comparison after the end of treatment.

Read notes that, rather than welcoming scientific discussion around the testing of a controversial procedure, “Gergel and colleagues portray research findings that are contrary to their opinions as somehow stigmatizing electroconvulsive therapy.”

Ultimately, according to Read, Gergel misstates their conclusions, misquotes the research, and argues that a procedure that hasn’t been appropriately tested since 1985—and which has worrying adverse effects—is psychiatry’s best hope.

 

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Read, J., Harrop, C., & Geekie, J. (2022). Time to acknowledge the bias of some electroconvulsive therapy researchers and defenders. Lancet Psychiatry, 9(2), e9. https://doi.org/10.1016/S2215-0366(21)00506-X (Link)

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Peter Simons
Peter Simons was an academic researcher in psychology. Now, as a science writer, he tries to provide the layperson with a view into the sometimes inscrutable world of psychiatric research. As an editor for blogs and personal stories at Mad in America, he prizes the accounts of those with lived experience of the psychiatric system and shares alternatives to the biomedical model.

8 COMMENTS

  1. BIAS? *BIAS*??…*B.*I.*A,*S.*???? No, that’s blatant false propaganda & LIES that the pro-Electrocution Torture(ECT) folks are spewing, thanks to the pseudoscience of psychiatry. Seems shrinks have a Dr. Frankenstein complex! Lancet Psych should be ASHAMED! But they’re shameless, aren’t they? Of course they are! They’re FRAUDS! My close friend was zapped with ECT, and the subtle damage and impairment seems permanent, especially in the face of the PILL RAPE she endures, of unwanted & un-needed psych drugs forced on her under Court order. And THIS is considered good standard of care medical treatment? My God…..

  2. To begin with, I’m sure they have some rigid protocol going on looking for those who think it’s a man’s (a woman’s a dog’s an angel’s a cat’s the mice and rat’s: rabbits, coyotes and deer fox antelope and Penelope herselve’s) duty to be there to herald new and improved care for themselves and others that will come from overlooking anything that points out it might not actually be what they have invested in just because it’s part of what goes on in a hospital. The rest being so unsafe that they themselves might have to deal with what they project on others not going round and round insulting circles.

    And it’s simple advertising. Who actually is paying the magazine to have ads in it? Again, psychic blinders for anyone who decides that that’s what needs to be done, gangs in outer space await you just as long as you don’t have too many light years to traverse, or you’d have to stop going round in circles.

    You aren’t going to get anywhere with those people, as little as trying to get the zoo to stop putting animals in cages and calling that entertainment. Or Hollywood having cars blow up, and stereotyping bad guys to the newest fashion, while acting like they are past their old ones, or how candy companies act like the stress caused to follow one’s thought thanks to their enhancement of your “taste” buds, that that’s building strength and commitment, just because it’s part of all of that (going to church, having birthday parties, holidays and other celebrations, and going “out”). You aren’t going to get anywhere with those people when you go into their “space” and start yanking about what they don’t want to see. I think what you need to do is YOURSELF do things differently, and that might attract more than the double edged sword of trying to use a system that’s not working to change what won’t.

    How long does it take to bang one’s head against a brick wall before one realizes it’s a brick wall? And then stop banging your head and it’s not a brick wall anymore. Sit in your own space, and they’ll see they have none, as much as they accuse you of invading there’s because you have your own, which they think there’s a lack of.

    I’m not saying don’t look at evidence, and gently point out the flaws. But let them go on, and on and on, and wait, and when there’s a lull, just gently point out once again the simple lack in evidence. And then the laugh, because they think there’s some great flaw of logic on your part, because you point something out akin to that The King isn’t really in charge, not the CEO, not even who’s on the white porcelain throne having received the most votes. Let them laugh, and then just quietly and gently point out how you don’t see there’s loss, but instead gain that doesn’t require loss, and…….

    There are only two choices:
    1) you simply are human
    2) being human is something that wasn’t given, and in being human others will steal it from you because it can’t exist in them when it’s recognized for what it is

  3. 1) It’s time to just disregard anything with financial conflicts of interests. Advertisements are not science.

    2) Anyone trying to repair a computer by random electric shocks would be rightfully considered insane. Brains are even more complex computers. There is no reason at all to assume that random electric shocks could do anything but damage to them.

    3) 0.1% vs. 0.2%. Okay, unless your sample size is way into the tens of thousands, that’s not gonna be even 5% significant.

  4. “there is no evidence that ECT is effective for its target demographic—older women ….” Is this evidence that psychiatry is – in fact – misogynistic?

    Many thanks to John Read for speaking the truth about psychiatry’s barbaric, controversial ECT procedure.

  5. My good friend is a daily-under-Court-orders, pill-raped drug-zombie VICTIM of the local “community mental health center”. She hates it, and her life. She has recently been going often to the local “peer support agency”, one not specifically aligned and involved with the C.M.H.C. During a group therapy session at the Peer Support Agency, another “consumer”,(…do they still call them that?…), was wondering about whether she should get Electro-Cution Torture, (ECT). My friend was given ECT, and wanted desperately to speak out to the woman, and dissuade her from the ECT. But subtle forces silenced my friend from sharing her voice, her personal experience with ECT. So it goes, Kurt, so it goes….(c)2022

  6. Read is being extremely patient with his political (oops – academic) opponents. To see this as anything other than a political battle at this point seems foolish to me. The criminals want a legal way to kill people. That’s all. I don’t think it is much more complicated than that.

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