The Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training, and Privileging: A Task Force Report of the American Psychiatric Association, 2nd ed.

Back to table of contents Previous article Next article Book Forum: TextbooksFull AccessThe Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training, and Privileging: A Task Force Report of the American Psychiatric Association, 2nd ed.RICHARD JAFFE, M.D., RICHARD JAFFESearch for more papers by this author, M.D., Philadelphia, Pa.Published Online:1 Feb 2002https://doi.org/10.1176/appi.ajp.159.2.331AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail The second edition of this APA Task Force Report updates the report on ECT originally released in 1990. ECT remains a treatment modality that generates strong emotional reactions, intermittent legislative action, and ambivalence within the medical community itself. If debate about the practice continues to generate more heat than light, this text represents a sincere and scholarly attempt to correct this.The basic format of the text has not changed from the 1990 edition. It provides a background discussion of selected ECT topics and a set of formalized recommendations in outline form. However, each of these has been expanded to reflect new insights into clinical aspects of treatment. For example, the increasing attention being paid to ECT as a continuation and maintenance treatment for the prevention of relapse and recurrence is reflected in the development of specific recommendations for these modalities, accompanied by model consent forms that reflect the change in focus from acute to maintenance care. Recommendations for stimulus dosing in the chapter on treatment procedures are based on empirical data published in 2000. The expanding indications for ECT in mood disorders, schizophrenia, and other medical disorders are described in the second chapter. A section on the selection of inpatient versus outpatient ECT reflects careful consideration of patient interests in the current managed care climate. The references cited for each section are updated, and there are four times as many as in the last report.The authors are balanced when discussing areas of controversy within the ECT field, and they are scrupulous in their efforts to be comprehensive. In addition to the obvious topics, i.e., how to perform the treatment and whom one should treat, they discuss the process of obtaining consent, the appropriate equipping and staffing of an ECT suite, appropriate documentation, and the critical issues of education, privileging, and training of ECT practitioners.Everyone involved in the selection, referral, or treatment of patients with ECT should obtain the report. It will stand as a practical first-line reference regarding most clinical questions and practical issues that might arise for some time. Everyone who intends to perform ECT in the immediate future, and for several years to come, should read it carefully.There is always the risk, in publishing a task force report, that one will be “preaching to the choir,” in this case, reinforcing beliefs and behaviors in a group that is already striving to use ECT responsibly and with the soundest possible empirical basis. Although the Task Force may not persuade ECT opponents to modify their position or correct all outmoded attitudes and practices, this report defines modern ECT treatment with clarity, conciseness, and careful science. Those already “in the choir” can be proud of their efforts.Washington, D.C., APA, 2001, 355 pp., $52.00. FiguresReferencesCited byDetailsCited byElectroconvulsive therapy for super refractory status epilepticus in pregnancy: case report and review of literature14 March 2022 | International Journal of Neuroscience, Vol. 133, No. 10Systematic review: Electroconvulsive therapy for treatment-resistant mood disorders in children and adolescents9 January 2022 | European Child & Adolescent Psychiatry, Vol. 32, No. 9Multiomics and blood-based biomarkers of electroconvulsive therapy in severe and treatment-resistant depression: study protocol of the DetECT study30 August 2023 | European Archives of Psychiatry and Clinical Neuroscience, Vol. 392Evaluation of the Online Component of a Blended Learning Electroconvulsive Therapy Curriculum for Psychiatry Residents to Treat Depression in Older Adults26 July 2023 | Academic Psychiatry, Vol. 18Neuroimaging Prior to ECT14 April 2023 | The Journal of ECT, Vol. 39, No. 2The clinical profile and outcome of patients receiving continuation electroconvulsive therapy (C-ECT): A retrospective study19 June 2023 | Indian Journal of Psychiatry, Vol. 65, No. 6Exploring New Electroencephalogram Parameters in Electroconvulsive Therapy12 May 2023 | The Journal of ECT, Vol. Publish Ahead of PrintAssociation between electroconvulsive therapy and depressive disorder from 2012 to 2021: Bibliometric analysis and global trends15 November 2022 | Frontiers in Human Neuroscience, Vol. 16Brain-Derived neurotrophic factor (BDNF) plasma level increases in patients with resistant schizophrenia treated with electroconvulsive therapy (ECT)22 February 2022 | International Journal of Psychiatry in Clinical Practice, Vol. 26, No. 4Electroconvulsive therapy effects on anhedonia and reward circuitry anatomy: A dimensional structural neuroimaging approachJournal of Affective Disorders, Vol. 313Electroconvulsive Therapy in Psychiatric Disorders: A Narrative Review Exploring Neuroendocrine–Immune Therapeutic Mechanisms and Clinical Implications22 June 2022 | International Journal of Molecular Sciences, Vol. 23, No. 13Anesthetic care for electroconvulsive therapyAnesthesia and Pain Medicine, Vol. 17, No. 2Electroconvulsive Therapy Before or After Initiation of Clozapine in Schizophrenia- A Retrospective Comparison for Seizure Parameters, Treatment Response and Duration of Hospitalization15 March 2022 | Acibadem Universitesi Saglik Bilimleri Dergisi, Vol. 13, No. 2Application of Brain Stimulation Techniques during Pregnancy31 December 2021 | Indian Journal of Private Psychiatry, Vol. 15, No. 2Absence of Longer Reorientation Times in Patients Undergoing Electroconvulsive Therapy and Concomitant Treatment with LithiumClinical Psychopharmacology and Neuroscience, Vol. 19, No. 4The priming effect of repetitive transcranial magnetic stimulation on clinical response to electroconvulsive therapy in treatment-resistant depression: a randomized, double-blind, sham-controlled study28 September 2021 | Psychological Medicine, Vol. 59Electroconvulsive Therapy in a Patient With Known Parietal Cerebral Cavernous Malformation19 January 2021 | The Journal of ECT, Vol. 37, No. 3A Narrative Overview of Current Anesthetic Drugs in Electroconvulsive Therapy18 September 2021 | Life, Vol. 11, No. 9Methylome-wide change associated with response to electroconvulsive therapy in depressed patients5 June 2021 | Translational Psychiatry, Vol. 11, No. 1The Practice of Electroconvulsive Therapy in Children and Adolescents in the Czech Republic22 October 2020 | The Journal of ECT, Vol. 37, No. 2Treatment‐resistant depression: An overview for psychiatric advanced practice nurses10 August 2020 | Perspectives in Psychiatric Care, Vol. 57, No. 2Do increases in deep grey matter volumes after electroconvulsive therapy persist in patients with major depression? A longitudinal MRI-studyJournal of Affective Disorders, Vol. 281Contemporary methods of non-drug therapy for depressionZhurnal nevrologii i psikhiatrii im. S.S. Korsakova, Vol. 121, No. 5Early and late effects of electroconvulsive therapy associated with different temporal lobe structures13 October 2020 | Translational Psychiatry, Vol. 10, No. 1Increased Risk of Pain after Electroconvulsive Therapy among Depressed Patients: a Nationwide Study in Taiwan10 December 2019 | Psychiatric Quarterly, Vol. 91, No. 1The effect of erythropoietin on electroconvulsive stimulation induced cognitive impairment in ratsBehavioural Brain Research, Vol. 382Anaesthesia in electroconvulsive therapy. Special conditionsRevista de Psiquiatría y Salud Mental, Vol. 13, No. 1Anaesthesia in electroconvulsive therapy. Special conditionsRevista de Psiquiatría y Salud Mental (English Edition), Vol. 13, No. 1The effect of electroconvulsive therapy on cerebral monoamine oxidase A expression in treatment-resistant depression investigated using positron emission tomographyBrain Stimulation, Vol. 12, No. 3Neuroimaging Before ECT?The Journal of ECT, Vol. 35, No. 1Archives of Women's Mental Health, Vol. 21, No. 6International Journal of Psychiatry in Clinical Practice, Vol. 18, No. 4African Journal of Medical and Health Sciences, Vol. 12, No. 2Non-Thermal Irreversible Electroporation (N-TIRE) and Adjuvant Fractionated Radiotherapeutic Multimodal Therapy for Intracranial Malignant Glioma in a Canine Patient1 February 2011 | Technology in Cancer Research & Treatment, Vol. 10, No. 1Intracranial Nonthermal Irreversible Electroporation: In Vivo Analysis29 July 2010 | The Journal of Membrane Biology, Vol. 236, No. 1 Volume 159Issue 2 February 2002Pages 331-331 Metrics History Published online 1 February 2002 Published in print 1 February 2002