Investigation On Cognition And Attitude Of ECT In Patients With Mental Disorders

BackgroundECT,it is often translated as electroconvulsive therapy or convulsive therapy.Clinically,it is often referred to as electroconvulsive therapy.MECT(modern ECT or modified ECT,hereinafter referred to as MECT),it is an improvement on traditional electroconvulsive therapy(ECT).The latter overcomes some shortcomings of traditional ECT and is now widely used in the treatment of various common mental diseases.Its efficacy and safety have been widely recognized,and in December 2018,the US Food and Drug Administration(FDA)lowered the risk level of ECT devices from Class III,the highest risk,to Class II.However,the use rate of ECT is very low,about 0.25%-1.43% in some European and American countries.Schizophrenia is the leading ECT indication in Asia,with only about 3.3% of ECT usage.The lack of awareness of ECT among patients with mental disorders may be an important factor affecting its use.ObjectiveQuestionnaire survey was conducted among patients with mental disorders to understand their understanding of ECT and the factors affecting their willingness to treat ECT,so as to provide evidence for rational use of ECT in clinical practice.MethodA questionnaire survey was used to collect the knowledge and attitude of 1077 inpatients with mental disorders in 10 psychiatric hospitals.The questionnaire mainly included basic demographic information and 18-item ECT Perception and Knowledge scale(ECT-PK).The subjects were grouped according to whether they were willing to receive ECT treatment or not,and the scores of demographic,ECT cognition scale and knowledge scale were statistically different.The factors that may affect treatment intention were analyzed by binary logistics regression.Results1.General situation: A total of 1077 subjects,aged between 10 and 81 years old,with an average of 36.92±13.69 years old;569(52.8%)were males,470(43.6%)were single,885(82.2%)had a high school education or less,697(64.7%)were unemployed,856(79.5%)had an annual income of less than 50,000,and 686(63.7%)were diagnosed with schizophrenia.2.Demographic characteristics: Patients who were willing to try ECT had a lower mean age(t=1.976,P=0.048),a higher rate of unemployment(X2 =13.761,P=0.003).The proportion of patients diagnosed with schizophrenia who were willing to receive ECT was significantly higher than those who were not(X2 =4.546,P=0.033),and the proportion of patients with major depressive disorder was significantly lower than those who were unwilling to receive ECT(X2 =12.748,P < 0.001).3.Scale score: The mean score of ECT cognition scale was 2.94±0.53,and the mean score of ECT knowledge scale was 4.83±2.24.The mean scores of ECT cognitive scale in patients who were willing to receive ECT were significantly lower than those who were not(t=-4.669,P < 0.001).The mean score of ECT knowledge scale in patients who were willing to receive ECT was significantly higher than that in the group who were not willing to receive ECT(t=16.001,P < 0.001).4.Results of binary logistic regression analysis: Variables such as "Electroconvulsive therapy is a lifesaving solution"(OR=0.832,95%CI: 0.709-0.978),"I trust professionally trained medical personnel to carefully complete electroconvulsive therapy"(OR=0.755,95%CI: 0.628-0.908),"Electroconvulsive therapy is used to treat suicidal behavior"(OR=1.580,95%CI: 1.155-2.160),"The treatment cycle of electroconvulsive therapy usually lasts for several weeks and is performed at least once a week"(OR=2.571,95%CI: 1.849-3.575),"Much scientific evidence supports the use of electroconvulsive therapy"(OR=1.973,95%CI: 1.372-2.838),"Electroconvulsive therapy is one of the safest medical techniques"(OR=3.048,95%CI: 2.223-4.178),"Average score of ECT Cognitive Scale"(OR=0.702,95%CI: 0.536-0.918),"Average score of ECT Knowledge Scale"(OR=1.596,95%CI: 1.488-1.712)were related factors affecting treatment intention.Conclusions1.Patients with mental disorders tend to have neutral cognition of ECT,lack of knowledge related to ECT treatment,and have low willingness to accept ECT treatment.The mastery level of ECT knowledge will significantly affect patients’ willingness to choose ECT treatment.2.The correct understanding of the indication,treatment course,science and safety of ECT can improve the willingness of patients to choose ECT.