Nigerian medical students attitudes to unmodified electroconvulsive therapy

Electroconvulsive therapy (ECT) is an effective and affordable form of treatment for a range of psychiatric disorders. Historical antecedents, the media, and movies have generated myths about its continued use and relevance.

We explored medical students' knowledge of and attitude to ECT on completion of an 8-week clinical rotation (clerkship) in psychiatry.

A cross-sectional survey was carried out among final-year medical students at the end of a clerkship in psychiatry using a self-administered questionnaire adapted from previously published work, to assess their attitudes to and knowledge of unmodified ECT.

Knowledge of medicine, psychiatry, and ECT were self-rated as average by most students. Most had an interest in pursuing psychiatry as a profession and would receive ECT if judged clinically appropriate. Most students had positive attitudes toward ECT; the vast majority thought it was a relevant form of treatment and did not think that ECT was used to control violent or used by government to torture opponents. Although an overwhelming majority did not think ECT was outmoded or causes permanent brain damage, answers about pain associated with ECT and about the dangers associated with the procedure seem to be more evenly split. A minority thought that ECT was used only in the poor and should not be given to the elderly or children. A substantial majority thought that ECT was the treatment of last resort. Respondents who were likely to choose psychiatry as a profession agreed that ECT causes pain, but disagreed that it was used by governments to torture political opponents or that it causes permanent brain damage. Students with minimal knowledge of ECT showed more negative attitudes toward the myth that ECT is misused and should be a treatment of last resort.

The similarity of the attitudes of students exposed to unmodified ECT with attitudes of students exposed to modified ECT suggests that modification has made little impact on the attitudes of health professionals. The importance of lectures, patient follow-up while on clinical rotations has significant contributions in shaping attitudes and should be harnessed during training.