الفهرس 
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Abstract
Electroconvulsive therapy is often a life-saving
treatment, which has been withheld from many until late in the
course of their illness because of the social stigma, not because
of the science. It could be a first line treatment however it is not
out of the continuing stigma. The stigma exists because ECT is
often still portrayed in the media in the relatively brutal way as
it was first done decades ago, i.e. without anesthesia. Today,
ECT is used in a much gentler and more humane way as
patients are first anesthetized prior to generating the therapeutic
seizure, thus avoiding the muscle movement once associated
with them. Unfortunately, there is very little information
available to the health care community and the general public
about how current ECT is used and so the stigma from the past
remains.
The stigma of ECT is one of the main issues that need to
be addressed worldwide, ECT is a technically advanced and
effective treatment that is often misunderstood and maligned by
the lay public and by psychiatrists as well public concern
continues as a result of negative media portrayal, This outdated
use of language leads to negative attitudes and prejudice.
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The mechanism of action of ECT is not fully known.
ECT affects multiple central nervous system components,
including hormones, neuropeptides, neurotropic factors, and
neurotransmitters.
The stigma associated with ECT is a specific area that
needs to be addressed given that ECT is both a technically
advanced and effective treatment that is often misunderstood
and maligned by not only the lay public but by psychiatrists as
well. Between 1938 and the 1950’s, there was extensive use of
ECT. During that period of time, ECT was the major treatment,
if not frequently the only biological treatment for mental illness.
from the 1950’s through the 1970’s, with the advent of
psychotropic medications (including the development of
neuroleptics and of tricyclic antidepressants), a decline in the
use of ECT was seen. In the 1970’s, concerns emerged related
to the side effects of psychotropic medications, including the
cardiovascular effects of the tricyclic antidepressants and the
potential for tardive dyskinesia with neuroleptics. This concern
resulted in a resurgence of interest in ECT and led to many
studies and reports evaluating the effectiveness of this modality.
Electroconvulsive therapy (ECT) is used frequently in
developing countries, but investigations of patients’ awareness
and perception of ECT are rare.
Print to PDF without this message by purchasing novaPDF (http://www.novapdf.com/)In Egypt using modified ECT that changing the name of
ECT (Electro Convulsive Therapy) to BST (Brain
Synchronization Therapy) has made a shift to the positive in the
family awareness and patient’s acceptance. Explaining to the
patient and family the procedure without the word convulsions
and that this treatment with anesthesia and muscle relaxants
will just produce blinking of the eyes rather than a full body
convulsion has helped save and help many patients who were in
need of this treatment.
We have noticed, anecdotally, a change in refusal and
stigma with a decrease in either after the introduction of these
new names in the university hospitals. In addition families were
more accepting of this treatment for a current episode of illness
having on earlier admissions accepted the patient’s admission to
hospital only with the proviso that they not receive “electric
treatment”. Such observations do require formal study.
Aim of the study was to Highlight the knowledge,
experience and attitudes concerning ECT from patients
perspective before and after receiving the treatment and
Highlight the knowledge, experience and attitudes concerning
ECT from relative perspectives before and after receiving the
treatment.
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The study was performed at Institute of Psychiatry, Ain
Shams University, department of Brain Synchronization
Therapy. It was designed to assess the patients’ knowledge
before receiving the first ECT session, attitude before and after
receiving ECT sessions, experience after receiving ECT
sessions. And also to assess the relatives’ knowledge, attitude
and experience. It was carried from March 2015 until July 2015
during which the study included 60 patients and their relatives.
The study included 60 patients and another 60 of their
relatives. 47 of the subjects were male (78.3%) and 13(21.7%)
subjects were females. 38 subjects were single (63.3%) and 22
(36.7%) subjects were married. 33 (55.0%) subjects were living
in rural areas and 27 (45.0%) subjects were living in urban
areas. 5 (8.3%) subjects were illiterate, 36 (60.0%) subjects had
school education with different school levels and 19 (31.7%)
subjects had a university education. 30(50%) subjects were
employed and 30(50%) unemployed. 23(38.3%) subjects were
diagnosed as Bipolar 1 disorder manic episode, 19(31.7%)
subjects were diagnosed as Major depression disorder and
18(30.0%) subjects were diagnosed as schizophrenia.
The study shows negative attitude toward ECT among
patients and their relatives before receiving it compared to after
receiving it. As, 76.7% of the patients were not glad to receive
Print to PDF without this message by purchasing novaPDF ECT and 68.3% of the relatives were not glad that their patients
received ECT.
The study shows there is shifting toward positive attitude
of the patients and their relatives (with more as regarding
relatives) toward ECT sessions after receiving it.. A much
larger and significant proportion of the relatives had clearly
positive attitudes on 11 of the 16 items. And, 63.3% of the
patients were glad to receive ECT and 88.3% of the relatives
were glad that their patients received ECT.
The study shows that the majority of the patients were
unaware of the basic facts about the procedure of ECT,
informed consent, indications, effectiveness, and side effects,
88.3% of the patients and 86.7% of the relatives. We found that
98.3% of patients and 95% of the relatives didn’t know about
informed consent. These results mirror the dominant trend in
literature, which suggests that patients who receive ECT often
know little about what it exactly involves.
We found no relation between attitude, knowledge and
experience and socidemographic values (gender, marital status,
residence and employment) except for the educational level
showing highly significant value with the experience of the
patients.
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The study shows that there is significant value between
depressed patients and their attitude toward ECT more than
BAD and schizophrenia.
The current study there is positive attitude and
experience toward ECT after receiving it among patient and
their relatives with poor knowledge among both of them