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Shock therapy on the rise in Sweden: report

Published: 18 Nov 2009 13:15 GMT+01:00
Updated: 18 Nov 2009 13:15 GMT+01:00

Swedish hospitals are increasingly turning to electroshock therapy to treat depression, but have failed to adequately warn patients about the risk for memory loss associated with the treatment, a Sveriges Television (SVT) report reveals.

“Four or five years of my life have just disappeared,” Helena, a mother of two, told the SVT investigative news programme Uppdrag granskning on an episode due for broadcast on Wednesday night, according to Aftonbladet.

After trying a number of different drugs which failed to have any effect on her depression, Helena underwent electroshock therapy, more formally known as electroconvulsive therapy (ECT), treatment in 2004.

While Helena’s medical files show that she was opposed to the treatment at the time, she was eventually convinced to proceed by her husband, who had been assured by doctors that there was only a slight risk of memory problems which wouldn’t last more than a few hours.

But after a few treatments, it became clear that ECT had had a profound negative effect on Helena.

“I came home with an entirely different wife this weekend. I’ve never met this person. What have you done?” Helena’s husband said he told hospital staff.

According to SVT, the number of ECT treatments carried out per year in Sweden has skyrocketed since 2000 from 18,000 to 45,000.

But patients may not always be made aware of the risks of ECT before agreeing to the treatment.

According to the programme, there are two versions of an informational brochure on ECT produced by Swedish psychiatrist Håkan Odeberg and based on the findings of the American Psychiatric Association (APA).

In the version distributed to patients, people considering ECT treatment can read that “research has not shown there to be any lasting memory impairments”.

But the version given to doctors says instead that research shows that patients risk permanent memory damage following ECT treatment.

When confronted with the discrepancy, Odeberg disputes the claim found in the doctors’ version of the brochure.

“I don’t see that as the scientific point of view, that ECT causes permanent damage,” he told Uppdrag granskning.

Helena was unable to have her case heard by Sweden’s Medical Responsibility Board (Hälso- och sjukvårdens ansvarsnämnd - HSAN) because more than two years had elapsed since the time of her ECT treatment.

Her husband remains haunted by the effects of his decision to go ahead with the treatment.

“I regret it now. I feel terrible with the knowledge that it was my word that resulted in it actually being carried out,” he told the programme.

David Landes (david.landes@thelocal.se)

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Your comments about this article

14:06 November 18, 2009 by Nemesis
ECT is not medical treatment, it is torture.

Torture is illegal in Europe. Sweden is in Europe.

If the police do not intervene, patients should take legal action.

No doubt the Swedish authorities would find in favour of the psychiatrists as usual. However upoin exhausting all legal options in Sweden a patient can take there case to the European Court of Justice, at which they will recieve compentsation of at least half a million krona, plus all costs and possibly more.

ECT is assault. The psychiatrists who practice it, know it is assault.
21:06 November 18, 2009 by Greg in Canada
ECT was popular in the 1940's and 1950's. I didn't think it was used much any more except in extreme cases of uni-polar or bi-polar depression. I wouldn't go as far as to label it as "torture". Patients undergoing this type of treatment would have to give their legal consent. I'm actually surprised to hear that it's making a come back.
21:28 November 18, 2009 by Nemesis
@ Greg in Canada

For decades now, human rights campaigners have been trying to get it labelled as torture.

A lot of clinicians consider it torture.

Most people undergoing ECT are not aware of the full facts, exactly as the article states.

It is only a matter of time before ECT is banned Europe wide. There is cases in the pipeline for the ECJ and ECHR on that very subject.
21:38 November 18, 2009 by entry
ECT as practiced today is totally different than as It was in the past and depicted in movies such as One flew over the CooKoo's Nest. It is an extreme course of treatment and one that should only be performed with informed consent of the patient. That seems to be the issue here. The husband talked the wife into the treatment and his claim is that he was not properly informed of any possible risks. I haven't heard anything in the news recently until this article today but I remember talking to people or reading about the procedure. I believe they have a whole team of medical people involved when ECT is performed and sometimes a defibrillator is needed to restart the patients heart. Many years ago I used to subscribe to the magazine Psychology Today, so I pulled up a couple of online articles on ECT. What they say there is pretty much what I thought about ECT.

Is ECT Worth the Risks? | Psychology Today

"ECT is usually done in a series of 10-15 separate treatments over several weeks. The electrical current has a disorganizing effect on the chemical/electrical makeup of the brain. It is believed that as the brain reorganizes, its chemical balance is restored. However, some brain cells are likely damaged in the process. Patients commonly complain of short-term memory loss. ECT patients may feel they have traded some recent memories for depression relief. But most say it's a fair trade. The treatment also carries the risk that attends any use of anesthesia. ECT is an extreme treatment, no doubt about it. Some doctors are more casual about it than others, but you shouldn't be. You may want to consult with some other psychiatrists for additional opinions to help you make a comfortable decision."

https://www.psychologytoday.com/articles/20...worth-the-risks

Postpartum Disorder (Treatments) | Psychology Today

"Electroconvulsive therapy (ECT) is useful, particularly for individuals whose depression is severe or life threatening or who cannot take antidepressant medication. ECT often is effective in cases where antidepressants do not provide sufficient relief. In recent years, ECT has been improved. A muscle relaxant is given before treatment, which is done under brief anesthesia. Electrodes are placed at precise locations on the head to deliver electrical impulses. The stimulation causes a brief (around 30 seconds) seizure within the brain. The person receiving ECT does not consciously experience the electrical stimulus. For full therapeutic benefit, at least several sessions, typically at the rate of three per week, are required."

http://www.psychologytoday.com/conditions/...?tab=Treatments
22:11 November 18, 2009 by karex
Vitamin D is much more effective in my opinion. I take it every year at the start of the winter season to stay clear of winter blues.

What's next, a comeback of the lobotomy? (or however you spell it)

Are we regressing?
00:02 November 19, 2009 by Nemesis
@ entry

I have known people who have been given ECT for not following religeous dogma, for being gay, for being a single mother in Ireland. Don't say it wasn't nbecause as a subscriber to psychology today you will know that.

If you think it is so great, let me perform ECT on you.

Then you can give an honest opinion.

ECT is torture. It is nothing else. It belongs wiht the diagnosis of hysteria in women.

ECT is purely to abuse, nothing else.

ECT has no place in modern society.

Psychology, psychiatry and sociology are nothing more than modern day religeons. They are social control mechanisms in which those not approved of are dealt with by drugs, threat of being drugged, ECT or removal from society without trial.

I have watched the drama around the DSM V revision unfold. I have seen those professions for what they are.
01:01 November 19, 2009 by entry
* You're entitled to your opinion.

* We see things differently.

* I'm sorry you're upset.

* I'm sure that's how it looks to you.

* Take a deep breath

I certainly do not know if your claim "I have known people who have been given ECT for not following religeous dogma, for being gay, for being a single mother in Ireland. " is real or part of some kind of delusion and nowhere in any of my posts did I suggest otherwise, as you implied.

* I know how upset/angry/_ _ _ _/disappointed you are, but that is the way it is.

Yes, in the past, I am aware that there were forced psychiatric ECT treatments, but I do not think you should personally demonstrate the traits that medical staff used as justification for forced ECT treatments to make a point.
08:21 November 19, 2009 by Nemesis
@ entry,

Dress up ECT whatever way you want. It is torture and abuse, plain and simple.

You are obviously a psychologist or in a related disipline.

You are defending the indefensible.

There is no place for ECT in modern society.
12:31 November 19, 2009 by Dr. Dillner
Nemesis,

Yes, when ECT was first introduced, its use and application were far too arbitary and ill-applied. I cannot speak to how and when it is applied in Sweden, but in the UK and USA, an "informed consent," as established by the WHO is required.

Thus, I disagree with you on your position that it is "torture." I believe that torture is something that is done against one's wishes; which is not the situation described by this woman and her husband.

The treatment remains controversial, but has been demonstrated to be efficacious. Here are two articles you might find interesting:

-Ross, C.A. (2006). "The sham ECT literature: implications for consent to ECT.". Ethical Human Psychiatry and Psychology 8 (1): 17-28.

-Lisanby, S.H., Maddox, J.H., Prudic, J., Devanand, D.P., Sackeim, H.A. (June 2000). "The effects of electroconvulsive therapy on memory of autobiographical and public events". Arch. Gen. Psychiatry 57 (6): 581-90.

As long as there is *informed consent* as described by WHO, then ECT can be a useful treatment -- has has sufficient documentation to support this. Here are the WHO guidelines:

http://www.who.int/mental_health/policy/resource_book_MHLeg.pdf

Finally, your position of, "There is no place for ECT in modern society," is a perfectly okay OPINION to hold, but you do not support it with any references or documentation.
19:17 November 19, 2009 by spy
I expect Nemesis knows quite a bit about treatment for mental illness. . .
09:56 November 20, 2009 by Nemesis
@ spy,

You can get help or more likely torture with your friend Dr. Dillner.
19:43 November 20, 2009 by skylarkpilot
There is quite a lot of information on Wikipedia about ECT.

I have to admit to having believed it went out of fashion years ago and was now consigned to the realms of quackery. Apparently I was wrong.

Putting being wrong aside, I wouldn't have it done to me or anyone in my family. The benefits appear to be very short lived and the dangers of memory loss appear to be understated to patients.

These kinds of poorly understood medical practises should surely be the focus of more research. This case in particular tends to support that hypothesis.

That's my two'pennorth anyways......
04:13 November 26, 2009 by steeleweed
I have known three people who received ECT, although not for depression.

They had all spent several years in mental hospitals. After one treatment, they improved enough to be released. However, all three admitted they were not cured and they simply said and did whatever the doctors wanted, in order to avoid another ECT treatment. They considered it torture, whatever the medical profession thought. My suggestion is that MDs should not be allowed to order ECT without having gone through it themselves.

An interesting side note is that in order to avoid a 2nd ECT, all three patients were able to fake sanity well enough to deceive the doctors. The implication is that insanity is to some extent a matter of choice. They were willing to put up with being confined to in a hospital, but ECT was too high a price to pay for whatever they got out of being institutionalized.
04:35 December 14, 2009 by Lauren Tenney
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