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Psychiatrists who use and do not use ECT: a comparative study
The Hillside Journal of Clinical Psychiatry
|January 1, 1981
Summary
Psychiatrists using electroconvulsive therapy (ECT) often have a somatotherapeutic orientation. ECT users were less psychoanalytically trained and treated more lower-class patients, using more pharmacotherapy and less intensive psychotherapy.
Area of Science:
- Psychiatry
- Clinical Psychology
- Medical Sociology
Background:
- The New Haven studies established a directive-organic orientation for electroconvulsive therapy (ECT) users.
- Contemporary psychiatric practice may have shifted this orientation.
Purpose of the Study:
- To test hypotheses about the characteristics of psychiatrists using electroconvulsive therapy (ECT).
- To compare ECT users with non-users regarding training, patient demographics, and treatment modalities.
Main Methods:
- Cross-sectional survey of 80% of Maryland psychiatrists.
- Comparison of 29 ECT users with 441 non-users based on a 10-page questionnaire.
- Analysis of demographic variables, training, and treatment practices.
Main Results:
- ECT users were less psychoanalytically trained, treated more working/lower-class patients, and used more pharmacotherapy and less intensive psychotherapy.
- Hypotheses regarding public hospital affiliation and short-term psychotherapy were not supported.
- ECT users used less behavior therapy; no female or child psychiatrists in the sample used ECT.
Conclusions:
- Findings support a somatotherapeutic orientation for ECT users, diverging from the older directive-organic concept.
- Psychiatrist characteristics and treatment choices associated with ECT use have evolved.
- Further research is needed to understand contemporary ECT utilization patterns.