Electroconvulsive therapy without consent from patients: one-year follow-up study

Area of Science:

• Psychiatry
• Neurology

Background:

• No prior studies analyzed reasons for electroconvulsive therapy (ECT) without patient consent.
• This study compares clinical characteristics and outcomes of patients undergoing ECT without consent.

Purpose of the Study:

• To compare clinical characteristics and one-year outcomes between patients who refused ECT and those lacking capacity for consent.
• To analyze the reasons for electroconvulsive therapy (ECT) administration without patient consent.

Main Methods:

• Retrospective cohort study of 29 patients treated with ECT without consent (2006-2010).
• Patients were categorized into consent-refusal or consent-incompetent groups based on their ability to refuse or understand ECT.
• Informed consent was obtained from surrogate family members.

Main Results:

• Patients diagnosed with schizoaffective disorder, psychotic disorder, bipolar I disorder, and major depressive disorder with psychotic features underwent ECT.
• Consent-incompetent patients had longer hospital stays and higher one-year recurrence rates compared to consent-refusal patients.
• While all patients showed rapid improvement, two-thirds experienced temporary remission, and 66% required rehospitalization within one year.

Conclusions:

• Electroconvulsive therapy (ECT) can be administered early, emergently, and successfully for various psychiatric disorders and life-threatening conditions.
• ECT can be used without legal repercussions, even during a patient's initial hospitalization.