IMAGES IN CLINICAL ECT
“Electroconvulsive Therapy” Image on PubMed Charles H. Kellner, MD, Elizabeth K. Schwartz, PhD, Emma T. Geduldig, BA, and Gabriella M. Ahle, BA
D
espite the established role of electroconvulsive therapy (ECT) as a standard medical treatment for serious depressive and psychotic disorders, it remains a target for ridicule, prejudice, and attacks.1 Many times, it is easy to spot these because they are blatant and appear in materials from outspokenly antipsychiatry organizations.2 Sometimes, however, the attack is insidious and surprising because it appears on a reputable site. Such is the case with the attached images (Figs. 1, 2). The image originally appeared in the Canadian Medical Association Journal3 in 2011 in a news article about the Food and Drug Administration hearing on the reclassification of ECT devices.4 We assume and hope that the editors of that journal were unaware of the inappropriate nature of the image. For the past several years, whenever one has searched the terms electroconvulsive therapy or electroconvulsive, the image has appeared in a box on the lower right-hand corner of the PubMed page. For someone who is knowledgeable about ECT, it is clearly a misleading and derogatory caricature, which was created to ridicule ECT or, worse, ECT patients. The image suggests that the man, with his wide-eyed stare, injected conjunctivae, and crumpled “electrodes,” has just had ECT. It is clearly staged and made to appear that the person is distraught. Such an image is frightening, off-putting, and totally inaccurate. It has no place on
a government Web site that serves as the leading source of medical information for the world. It is unfortunate that thousands of viewers have had to be exposed to this, likely among them prospective patients who may have been scared off from having the treatment. As medical practitioners, we have a responsibility to ensure that inaccurate and (perhaps purposely) misleading information is not promulgated in the guise of scientific and clinical knowledge. REFERENCES 1. Euba R, Crugel M. The depiction of electroconvulsive therapy in the British press. J ECT. 2009;25:265–269. 2. Fink M. Impact of the antipsychiatry movement on the revival of electroconvulsive therapy in the United States. Psychiatr Clin North Am. 1991;14:793–801. 3. Benac N. United States reviews safety of electroconvulsive therapy. CMAJ. 2011;183:E269–E270. 4. FDA Executive Summary. Available at: http://www.fda.gov/downloads/ AdvisoryCommittees/CommitteesMeetingMaterials/MedicalDevices/ MedicalDevicesAdvisoryCommittee/NeurologicalDevicesPanel/ UCM240933.pdf. Accessed December 11, 2014. See more at: http://www.psychiatrictimes.com/electroconvulsive-therapy/ fda-advisory-panel-reclassification-ect-devices#sthash.Jeb5edNo.dpuf.
FIGURE 1. Screenshot from PubMed search of “electroconvulsive.”
From the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY. Reprints: Charles H. Kellner, MD, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY 10029 (e‐mail: [email protected]; [email protected]). Dr Charles H. Kellner receives grant support from the National Institute of Mental Health; royalties from Cambridge University Press; and honoraria from UpToDate, Psychiatric Times, and North Shore-LIJ Health System. The other authors have no conflicts of interest or financial disclosures to report. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. DOI: 10.1097/YCT.0000000000000219
Journal of ECT • Volume 31, Number 3, September 2015
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
www.ectjournal.com
141
Journal of ECT • Volume 31, Number 3, September 2015
Kellner et al
FIGURE 2. Original image from the Canadian Medical Association Journal, 2011.
142
www.ectjournal.com
© 2015 Wolters Kluwer Health, Inc. All rights reserved.
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
“Electroconvulsive Therapy” Image on PubMed Charles H. Kellner, MD, Elizabeth K. Schwartz, PhD, Emma T. Geduldig, BA, and Gabriella M. Ahle, BA
D
espite the established role of electroconvulsive therapy (ECT) as a standard medical treatment for serious depressive and psychotic disorders, it remains a target for ridicule, prejudice, and attacks.1 Many times, it is easy to spot these because they are blatant and appear in materials from outspokenly antipsychiatry organizations.2 Sometimes, however, the attack is insidious and surprising because it appears on a reputable site. Such is the case with the attached images (Figs. 1, 2). The image originally appeared in the Canadian Medical Association Journal3 in 2011 in a news article about the Food and Drug Administration hearing on the reclassification of ECT devices.4 We assume and hope that the editors of that journal were unaware of the inappropriate nature of the image. For the past several years, whenever one has searched the terms electroconvulsive therapy or electroconvulsive, the image has appeared in a box on the lower right-hand corner of the PubMed page. For someone who is knowledgeable about ECT, it is clearly a misleading and derogatory caricature, which was created to ridicule ECT or, worse, ECT patients. The image suggests that the man, with his wide-eyed stare, injected conjunctivae, and crumpled “electrodes,” has just had ECT. It is clearly staged and made to appear that the person is distraught. Such an image is frightening, off-putting, and totally inaccurate. It has no place on
a government Web site that serves as the leading source of medical information for the world. It is unfortunate that thousands of viewers have had to be exposed to this, likely among them prospective patients who may have been scared off from having the treatment. As medical practitioners, we have a responsibility to ensure that inaccurate and (perhaps purposely) misleading information is not promulgated in the guise of scientific and clinical knowledge. REFERENCES 1. Euba R, Crugel M. The depiction of electroconvulsive therapy in the British press. J ECT. 2009;25:265–269. 2. Fink M. Impact of the antipsychiatry movement on the revival of electroconvulsive therapy in the United States. Psychiatr Clin North Am. 1991;14:793–801. 3. Benac N. United States reviews safety of electroconvulsive therapy. CMAJ. 2011;183:E269–E270. 4. FDA Executive Summary. Available at: http://www.fda.gov/downloads/ AdvisoryCommittees/CommitteesMeetingMaterials/MedicalDevices/ MedicalDevicesAdvisoryCommittee/NeurologicalDevicesPanel/ UCM240933.pdf. Accessed December 11, 2014. See more at: http://www.psychiatrictimes.com/electroconvulsive-therapy/ fda-advisory-panel-reclassification-ect-devices#sthash.Jeb5edNo.dpuf.
FIGURE 1. Screenshot from PubMed search of “electroconvulsive.”
From the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY. Reprints: Charles H. Kellner, MD, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY 10029 (e‐mail: [email protected]; [email protected]). Dr Charles H. Kellner receives grant support from the National Institute of Mental Health; royalties from Cambridge University Press; and honoraria from UpToDate, Psychiatric Times, and North Shore-LIJ Health System. The other authors have no conflicts of interest or financial disclosures to report. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. DOI: 10.1097/YCT.0000000000000219
Journal of ECT • Volume 31, Number 3, September 2015
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
www.ectjournal.com
141
Journal of ECT • Volume 31, Number 3, September 2015
Kellner et al
FIGURE 2. Original image from the Canadian Medical Association Journal, 2011.
142
www.ectjournal.com
© 2015 Wolters Kluwer Health, Inc. All rights reserved.
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
