Psychiatric Electroceutical Interventions-Really?

Out on PubMed, from researchers at Michigan State University, is this study:

Last Resort Interventions?: A Qualitative Study of Psychiatrists' Experience with and Views on Psychiatric Electroceutical Interventions.

Cabrera LY, Nowak GR 3rd, McCright AM, Achtyes E, Bluhm R.Psychiatr Q. 2020 Aug 13. doi: 10.1007/s11126-020-09819-1. Online ahead of print.PMID: 32789719

The abstract is copied here:

Psychiatrists play an important role in providing access to psychiatric electrical interventions (PEIs) such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS). As such, their views on these procedures likely influence whether they refer or provide these types of treatments for their clinically depressed patients. Despite this, scholars have too infrequently examined psychiatrists' views about specific PEIs and have not yet examined their views across different PEIs. To gain insight into psychiatrists' views about PEIs, we conducted a qualitative study based on semi-structured interviews with 16 psychiatrists in Michigan. The majority of psychiatrists had a positive attitude towards PEIs in general. One-third reported cautionary attitudes towards PEIs; they did not reject the interventions but were skeptical of their effectiveness or felt they needed further development. The majority of psychiatrists consider ECT and TMS to be viable therapies that they would discuss with their patients after several failed medication trials. There was a lack of knowledge about surgical PEIs, such as deep brain stimulation. This study provides insights into how psychiatrists perceive PEIs. While broadly positive attitudes exist, this research highlights certain challenges, particularly lack of knowledge and ambiguity about the use of PEIs.


Keywords: Deep brain stimulation; Depression; Electroceuticals; Electroconvulsive therapy; Transcranial magnetic stimulation.

This is a study in which 16 Michigan psychiatrists were interviewed about their attitude and knowledge of four "psychiatric electroceutical interventions" (PEIs): ECT, TMS, DBS and ABI (adaptive brain implants). 

Perhaps the authors had good intentions, but there is very little good in this article. Let's start with the words "last resort" in the title and the nonsense word "electroceutical." Lumping together these interventions based on the use of electricity is pretty ridiculous. And that is my main complaint with this paper: lumping in ECT with other treatments that have meagre histories of clinical utility and are not comparable in any way. ECT is a standard treatment in modern psychiatric medicine with a long track record of success in the relief of severe mood and psychotic disorders. It should not be lumped in with the other "PEIs."

The authors try to make the case that more education needs to be done about these modalities; agreed, but let's start by making sure we know which of these things is not like the others (in a good way).