ECT in Italy- A Regrettable State of Affairs
Out on PubMed, from clinicians and researchers in Italy, is this editorial:
The shocking attitude towards ECT in Italy.
CNS Spectr. 2020 Dec 4:1-12. doi: 10.1017/S1092852920002059. Online ahead of print.PMID: 33280623
From the text:The editorial begins:
The recent factious and misleading opinion paper by Read and colleagues , corroborated by a handful of commentaries such as the one by Bental deserves some considerations, emphasizing the Italian scenario. Electroconvulsive therapy (ECT) was introduced and successfully delivered by two Italian scientists and clinicians, Lucio Bini and Ugo Cerletti (1938). The amazing efficacy on serious life threatening cases of melancholia, psychotic and delirious mixed states and catatonia was so evident that it spread within a couple of years to all of Italy and the rest of the world. Since then, hundred thousands of lives have been saved despite the quality of clinical studies is “not good enough” to convince Read and colleagues that ECT is “effective for its target”.
The editorial concludes:
The new generation of Italian psychiatrists do not know, or worse, have prejudices about ECT; they have never seen it being practiced, nor have they studied it, nor have attended lectures about it unless they had the chance to practice abroad or to get in touch with the previous generations of expert clinicians. Consequently they are not familiar with the identification of life threatening syndromes such as catatonia or delirious mood states. Today, in Italy, it is likely that an indefinite number of these patients are not recognized and end up in infectious disease or neuro-rehabilitation wards, without receiving a treatment that, according to the available data, would be effective in more than 80% of cases.
Thus, the present paper is meant as a plea for further academic attention towards the practice of ECT in Italy, a warning towards a critical appraisal of the evidence, especially when it is flawed, and a reinforcing message to practice in the real-world setting managing severe patients before making "science" an ideological pitfall which may ultimately harm the suffering ones.
This excellent editorial is in response to:
John Read is a well-known anti-ECT activist and the above review is fake news in a bogus journal.
One wonders if it is best to not even rise to the bait, versus responding in print with facts.
Our Italian colleagues have done the latter and kudos to them for it! (There will be more such rebuttals in the coming months.) They document the ironic and regrettable lack of ECT availability in Italy, the nation where ECT was invented.
I recommend a full read of this editorial (~10 minutes) when you can access the full text.
The below comment is from the first author, Dr. Cattaneo:
ReplyDeleteFirst of all I am very grateful to Professor Kellner for this important endorsement. I ask everyone to share and spread this editorial because of its relevance. I hope Italian clinicians and researchers may read it and help me to fight for ECT. Thank you again! More comments are welcome.