What's wrong with "ECT"?

The Nomenclature of Electroconvulsive Therapy

ABSTRACT

Electroconvulsive therapy (ECT) is an established but stigmatized psychiatric treatment. The term ECT reflects the treatment's modality and action. Several authors proposed different names for ECT to deal with stigma; however, available literature that promoted different names did not address the risk/benefit ratio or offer evidence-based approach to the efficacy of this approach. We aim to examine proposed names for their specificity, accuracy, understandability, and popularity. In addition, we aim to find evidence-based methods to combat the ECT-related stigma. We reviewed the literature relating to the proposed names using snowballing technique for literature search. Known ECT alternative names were used for search, and whenever another name appears, it was added to our search list. We conducted Medline, PsycINFO, Google Scholar, and PubMed search to check for popularity and cross examine whether proposed terms refer back to ECT. We searched for ECT and stigma, to find evidence for methods to tackle ECT-related stigma. Once, the search stopped yielding newer ideas, we stopped the search at a point of saturation, where no more ideas where generated. Our name search yielded 14 terms. Nine names avoided "electricity" and "convulsion," because of perceived associated stigma. Presence of different terminology can affect the clarity of patient-doctor communication, with no evidence of added benefit. Alternative names may affect doctor-doctor communication about this treatment. We concluded that it is safer to retain the term ECT for the sake of consistency and clarity of communication. Education and experience are evidence-based effective methods of tackling ECT-related stigma.

The influence of name on the acceptability of ECT: the importance of political correctness

BACKGROUND

Attitudes toward a treatment influence the acceptability of the treatment. There has been no study of how attitudes toward electroconvulsive therapy (ECT) are influenced by what ECT is called.

METHODS

A sample of 125 laypersons was drawn from 3 social settings in Bangalore, India. A short, oral questionnaire was administered to determine the acceptability of ECT under 3 different names: 2 actual and 1 coined.

RESULTS

The acceptability of ECT was highest for the coined name electrostimulatory therapy (53%), intermediate for the occasionally used name electroshock therapy (38%), and least for the commonly used name electroconvulsive therapy (9%) (P < 0.001). Electrostimulatory therapy was the preferred choice because it was least associated with the likelihood of harm (P < 0.01).

CONCLUSIONS

How a treatment is presented may influence reactions to it and, hence, its acceptability. We therefore suggest that ECT is better described as electrostimulatory therapy than as electroconvulsive therapy or electroshock therapy. We further suggest that discussions on ECT should emphasize the stimulatory effects of the treatment and downplay parallels with epilepsy. In an age of political correctness, political correctness should be applied to the description of ECT.