A Study of Psychiatrists' Attitudes and Concerns toward the Practice and Stigma Associated with Electroconvulsive Therapy

Background: Electroconvulsive therapy (ECT) has shown to have efficacy and safety in treating psychiatric disorders. Studies have shown psychiatrists harboring negative attitudes about its use. The aim of the study was to assess the attitudes of psychiatrists toward practice and use of ECT and stigma associated with it. Methodology: A self-designed questionnaire was mailed electronically. Participants were asked to rate their attitudes and experience of using ECT in practice, concerns faced during prescribing ECTs, and possible solutions for destigmatization of ECTs. Results: We received 483 valid responses. Majority had positive attitudes toward the current use of ECT. Practicing in a metropolitan city, working in multiple clinics, having a family history of psychiatric illness, and having a member of the family treated with ECTs were associated with significantly more positive attitude and less concern about ECT. Poor socio-occupational strata, poor financial status, poor educational status, diagnosis of psychosis, and history of suicidal illness were associated with better acceptance of ECT by patients and caregivers. Improving undergraduate education in psychiatry and ECT and organizing interactions between patients advised ECT and patients improved with ECT were felt as effective solutions to counter ECT-related stigma by most number of psychiatrists. Conclusions: Psychiatrists in India have positive attitudes toward ECT yet have major concerns about caregiver reactions and patient dropouts while prescribing ECT. Practice location and prior exposure to psychiatric illness and ECT affect attitudes toward ECT. Psychiatrists suggested multiple strategies to reduce stigma associated with ECTs, changing the name of ECT to a nonstigmatizing was one of them.