Long-Term Adverse Effects After Electroconvulsive Therapy (ECT): A Narrative Analysis Exploring People's Experiences, Meaning-Making and Coping.

Abstract

Approximately 2,500 people receive ECT annually in the U.K. Despite this, there are concerns about adverse effects of ECT, the accuracy of informed consent information and iatrogenic harm. Very few studies have focused on peoples’ experience of ECT, and fewer still have focused on peoples’ long-term experiences. The experience of ECT is known to be complex, requiring qualitative exploration. Therefore, this study aimed to explore the long-term adverse experiences of ECT, including psychological impacts, meaning-making and coping. Narrative analysis considered thematic, structural and performative elements of 7 peoples’ stories. Themes were explored across the timeline of participants’ experiences. Before ECT, participants felt misinformed regarding ECT and misunderstood by healthcare professionals. Immediately following ECT, participants noticed initial changes in their cognition, memory and mood. Returning home was important in participants’ discovery of differences. Long-term impacts were loss (of ability, memory, humanity and connection), the realisation that ECT had been damaging, and understanding ECT to have caused brain damage. Participants coped with adverse experiences by using prompts and strategies and connecting with others. Participants experienced a lack of follow-up care and denial of their experiences, which could contribute to psychological iatrogenic harm. An unexpected finding was the extensive nature of loss experienced by participants, which was comparable to the concept of ambiguous loss. Further research is needed into the adverse long-term effects of ECT, especially considering cognitive effects, memory loss and how these contribute to a changed sense of self. Service development is urgently required, especially for ECT follow-up care.

Date of Award	19 Nov 2024
Original language	English
Awarding Institution	University of Plymouth
Supervisor	David Murphy (Director of Studies (First Supervisor))