Abstract
There has been recent debate regarding the efficacy of electroconvulsive therapy in the treatment of depression. This has been based on narrative reviews that contradict existing systematic reviews and meta-analyses. In this special article, we highlight the mistakes that occur when interpreting evidence using narrative reviews, as opposed to conventional systematic reviews and meta-analyses.
Highlights
Electroconvulsive therapy (ECT) has been used in the treatment of major mental illness, depression, since its initial recorded use in 1938 (Cerletti and Bini, 1938)
A group of mental health professionals, patients and relatives recently wrote to the Chair of the Care Quality Commission (CQC) in the UK, stating: ‘Given the high risk of permanent memory loss and the small mortality risk, the longstanding failure to determine whether or not ECT works means that its use should be immediately suspended until a series of well designed, randomised, placebo controlled studies have investigated whether there really are any significant benefits against which the proven significant risks can be weighed’ (Read, 2020)
In a systematic review and meta-analysis, the UK ECT Review Group (UK ECT Review Group, 2003) identified six relevant trials, demonstrating ECT was more effective than simulated ECT (sECT) with a large standardised effect size of −0.91
Summary
Cite this article: Meechan CF, Laws KR, Young AH, McLoughlin DM, Jauhar S (2022). A critique of narrative reviews of the evidence-base for ECT in depression. Epidemiology and Psychiatric Sciences 31, e10, 1–8.
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