Talk:Electroconvulsive therapy/Archive 3

message: It is totally banned in some countries due to significant questions about its benefit. I do not see a mention of countries who have decided that it is unethical to treat patients with this method. I question the positive slant in the article and request that the article be edited to reflect the true controversy on this topic. —Preceding unsigned comment added by 203.59.117.96 (talk • contribs) 
:I don't think there are any countries where ECT is totally banned, that is where the government has told psychiatrists that they must not use ECT. There are one or two where psychiatrists have decided to stop using ECT, for example Slovenia. I will put something about Slovenia in the current use section. Staug73 14:15, 18 March 2007 (UTC)
replies: text: I have added Slovenia to the current use section, and also added quite a bit to the controversy section. Footnotes for Cameron and Bailey to follow.Staug73 18:37, 20 March 2007 (UTC)

text: I think the "drilling holes" you're talking about is called Trepanation , and it wasn't really used to "let the spirits out."  Osillaj 00:59, 17 May 2007 (UTC)
thread_title:  Is the article biased? 

message: I have removed 74.33.121.113's addition pending a more specific source. 74.33.121.113 was it an article you read on ect.org? If so, which one?
"ECT.org reports that 80 percent see results with a full treatment. A full treatment usually consists of 3 treatments a week for 2 to 4 weeks" 
I take the point that the Surgeon General is quoting typical figures, and that individual pieces of research have come up with higher or lower figures. I will find a couple of examples.
The number and frequency of treatment is already covered in overview and in current use.Staug73 10:59, 24 March 2007 (UTC)
thread_title:  Effectiveness 

message: I have removed footnote 61 as it was the only footnote in the famous people section. I think it is enough to click on the name and then people can find books etc. Many of the people on the list wrote books, have websites etc, if they all had a footnote there would be 100s. I think it would be a good idea to keep this section footnote free. What do other people think? Also you need to say why someone is famous (I have called Andy Behrman an American writer). I am not sure if he actually belongs in this section - all the other people were famous for something other than having had ECT. Is Andy Behrman famous for anything?Staug73 14:38, 16 April 2007 (UTC)
thread_title:  Footnotes in famous people 

message: Created new article for this section. It was getting very large. --scuro 02:18, 30 April 2007 (UTC)
thread_title: controversy [2]

message: I have made a few changes to the intro, which should serve as a brief explanation of ECT for readers with a short attention span, and not at least put off readers who want to continue with the article. I think it is important to keep the intro (and possibly overview) free from footnotes.
I have removed the sentence about catatonia because only a small minority of ECT patients have the diagnosis of catatonia and it rather repeated an earlier sentence about ECT usually being used where drugs have failed.
I have adjusted the sentence about "minority of health professionals...etc" to more accurately reflect what has emerged from various surveys.
The bit about patients being divided in their opinions of ECT comes from a wide range of sources for example the NAMI-NIMH consensus conference which is in the list of internet sources if anyone wants to check.Staug73 13:43, 30 April 2007 (UTC)
thread_title:  Intro 

message: In addition to the physiological effects, ECT may also have adverse psychological effects, counterproductive to its commonly stated goal. These effects may include post-traumatic stress disorder. Instances of such a case have been recorded by David Armstrong.
I didn't want to cut this bit as I didn't put it in, but I am anxious to remove the "unsourced statement" tag so I have moved it here. Following the link, it appears that this is an unpublished paper. Perhaps someone would like to find a published reference.131.111.164.231 15:40, 30 April 2007 (UTC)
thread_title:  Psychological effects 

message: "It took many years for these modifications to be widely adopted and even today they are not universally used. In the USA and the UK for example, bilateral electrode placement is still used more commonly than unilateral, with many psychiatrists finding bilateral more effective and easier to use although there is widespread agreement that it causes more memory loss than unilateral."
Someone queried this, but I am not sure which bit they are querying. I have moved the Kiloh footnote to the end of the sentence as they discuss this at some length (the fact that unilateral is not widely used although it is generally considered to be less damaging). Of course Kiloh doesn't include the latest figures for electrode placement in UK and USA but the USA figures are in the next sentence. In the UK electrode placement is nearly always bilateral - I think the reference is somewhere in the article (current use?) but if people think it is important I can reword this bit and put in another footnote.131.111.164.231 15:49, 30 April 2007 (UTC)
thread_title:  Techniques and equipment 

message: I have reinstated a brief mention of surveys showing extent of different views, and a short quote from consensus panel summarising reasons for controversy. Staug73 16:43, 30 April 2007 (UTC)
thread_title:  Controversy [3]

message: You may think a citation in not needed or that something is obvious but I have inserted a request for citations  for information which seemed far fetched, biased, or extraordinary. No one should be removing citation requests without first getting a consensus in discussion. Granted, when things are explained in discussion obvious ideas to you may become obvious to all...but we are no where near that step.
Now we have a problem. I believe the article has major POV problems. It will take several edits to get it to a more neutral POV. The first step was to ask for citations where information was possibly used in a POV way. These citation requests have been removed without consensus. I'd ask that the person(s) responsible for doing this reinsert the citations. The only other solution is to revert the article back to last night when the citations were put in. If I did that all edits since then would be obliterated. 
I'D ASK THAT ALL EDITORS HOLD OFF ADDITIONAL EDITS ON THE ETC ARTICLE UNTIL THIS ISSUE IS RESOLVED. YOUR EDIT MIGHT GET DELETED.--scuro 00:04, 1 May 2007 (UTC)
thread_title: you may think a citation isn't needed

message: Sorry to do this to some editors but no one should delete citation requests and no one wanted to reinsert them into the current article. --scuro 16:46, 1 May 2007 (UTC)
replies: text: I had just finished adding footnotes when you reverted. If you had checked the history page you would have seen a long list done this afternoon. I had looked back to your version of 12:02 30 April, noted all your citation requests and then either supplied at least one reference, or changed or removed text so that a footnote wasn't needed. By the way the two footnotes at the end of paragraph on anterograde/retrograde amnesia (Benbow and Rudorfer I think) cover all the points in that paragraph. I don't think I have missed any of your citations, but let me know if I have. Since all the citations you requested have been provided I shall now remove the NPOV tag. If you wish to re-instate it, please be specific about which sentences are NPOV.Staug73 17:01, 1 May 2007 (UTC)
thread_title: I have reverted the article back to predelete version

message: "but has a high rate of relapse"-this needs a good citation and "high" needs to be defined.
"A small minority of psychiatrists, a larger minority of other mental health professionals and a majority of the general public are skeptical of it's overall benefits and it remains a controversial treatment[citation needed]. Those who have undergone ECT treatment are divided in their opinion of it[citation needed]"
A study from Britan or Australia doesn't cut it as a source for any of the above statements. What happens there doesn't necessarily happen in the rest of the world. Reword, provide further citations, or delete that section. The statement, "divided in their opinion" does state anything. Society is virtually divided in their opinion on most intervention...eg counselling. Reword or delete. that sentence.--scuro 12:10, 2 May 2007 (UTC)
replies: text: I have removed the above paragraph because it was slightly clumsy, the points are covered in more detail elsewhere and I think it is important to keep the introduction brief, factual and footnote-free. I have inserted "controversial" into the first paragraph because it accepted by virtually everyone that ECT is controversial. For references see the controversy section. Plus I have removed the POV tag as the article is now impeccably sourced and neutral. If anyone can spot any POV statements please draw them to my attention and I expect there is something we can do about them.Staug73 13:40, 2 May 2007 (UTC)
replies: text: In reading the Rudorfer overview, the effectiveness of the treatment is repeatedly mentioned, especially if the treatment is individualized for the patient and the treatment is used for specific disorders where it has been shown to be effective. eg an acute episodic case of depression. In some instances ETC should be the first line of treatment when the patient is an immediate danger to themselves...eg suicide. What can be regarded as the intro's only mention of the effectiveness of the treatment would be the line, "but it has maintained an important place in psychiatry". Changes should be made...any objections? --scuro 13:56, 5 May 2007 (UTC)
thread_title: the intro

message: I have put this section back even though I didn't put it in because I don't think it should have been removed. Could I draw attention to the Information suppression section in the Wikipedia:NPOV tutorial especially
"Entirely omitting significant citable information in support of a minority view, with the argument that it is claimed to be not credible." 
That said, I am not convinced that the Breeding quote is in the right place or presented in the right way. I will give it some thought.Staug73 16:06, 2 May 2007 (UTC)
thread_title:  Psychological effects 

message: At least two editors see multiple POV issues with the article. Personally, I see bias in many sections of the article. I am estimating that it would take me hours to research, and then list all all the potential POV issues of the article in one post. Instead of one large post, I'm going to work from top to bottom. This morning I started with the intro. From my perspective this section no longer has POV issues. Thank you for editing the intro. I'll go down each section as I have time. This process will take several days. DO NOT REMOVE THE POV TAG UNTIL THIS PROCESS IS COMPLETE. In fact, the unilateral removal of citation requests and POV tags has slowed me down significantly in that I have to respond to this as I am doing now. --scuro 16:38, 2 May 2007 (UTC)
thread_title: DO NOT REMOVE POV TAG UNILATERIALLY

message: I have moved a sentence from Current use to Treatment to replace this sentence: "The vast majority of ETC paitents are also white." I think minority is a more appropriate term (isn't it the one that Rudorfer uses?). Statements like this very much need footnotes. It had a footnote in Current use which I have just moved with it. I think it is important to specify which country you are talking about as well, Rudorfer is only referring to the US. Don't forget this is an English language encyclopedia, not just American. In the UK, for example, the situation is slightly more complicated. The statistics I have seen would suggest that white people are overrepresented among consenting ECT patients but not amongst non-consenting patients. But I don't think the UK statistics are sound enough to mention them in the article. Staug73 14:10, 3 May 2007 (UTC)
thread_title:  Minority patients 

message: I have moved a few sentences from the controversy section to what seemed to be the most appropriate section in the rest of the article, and deleted everything that might be considered historical, that is, from 1940 to 1980. I have also written something for the new controversy article. I very much hope that people are satisfied with this. I don't mind if the controversy section here goes or stays.Staug73 17:23, 3 May 2007 (UTC)
thread_title:  Controversy over controversy 

message: Is not a good source for main sections of this article because he represents neither a minority or majority viewpoint. His opinion should be considered a fringe opinion neither based on current research nor the established viewpoint in that field. As quoted above he believes, "Electroshock always causes brain damage". The Psychological effects section which were observations of his, were moved to ECT controversy article. --scuro 20:33, 5 May 2007 (UTC)
thread_title: John Breeding

message: Changed the title from an origin of ECT to a history of ECT. This section should go right up to the present day. This history should be a synopsis of major events and not go into specific details that have little of no relevance to the topic. For instance we learn that in the first experiments of ECT electrodes are attached to a dogs anus. The history of ECT will be long enough without such details. Someone has done a lot of work. Perhaps this material should be inserted in the Ugo Cerletti article. More edits to come. --scuro 22:22, 5 May 2007 (UTC)
thread_title: History of ECT

message: Wikipedia is the first entry listed when one searches google under the term(s) electroconvulsive or electroconvuslsive therapy. This article still has a ways to go to even being simply an acceptable source of information...and that opinion comes from someone who isn't even remotly an expert in this field. --scuro 18:49, 6 May 2007 (UTC)
replies: text: The is pretty much the case with any google search, which is why there are so many people keen to insert their POV into our articles. Perhaps you should request a peer review of this article to get some outside input. Rockpocket 19:30, 6 May 2007 (UTC)
replies: text: Intersting concept...peer review, how would Wiki do this, and who would be the "peers"? Ideally several people in field who are familiar with the procedure would examine this article.--scuro 20:32, 7 May 2007 (UTC)

text: I'm not quite sure what JuneTune means - sarcasm doesn't come across too well on the written page. Everyone is welcome to contribute to a peer review. See Wikipedia:Peer review for how to request one. Rockpocket 05:57, 12 May 2007 (UTC)

text: Yes, I see what you mean now. I am afraid you do have a point. Its very difficult to edit articles from a neutral point of view - as our policy demands - when one has been so closely involved witht he subject in such a negative context. Editors who insert critical firsthand knowledge into articles do tend to be marginalised because it rarely meets our reliable source criteria, and on the odd occasion it does, there are then conflict of interest concerns. If your aim is to share your negative experiences, then this really isn't the place for you. Nevertheless, your opinion is still welcome at a peer review, as long a you have comments that can improve the article, bearing the 5 pillars in mind. Rockpocket 01:17, 14 May 2007 (UTC)

text: Remember our criteria for inclusion is "verifiability, not truth". Its not our job to critique "flaws being put forward by mainstream psychiatry", its our job to record the mainstream view and then record other significantly notable minority views, affording each the commensurate weight. Even if the mainstream is hopelessly flawed (in your opinion), than Wikipedia will be hopelessly flawed too. While we certainly do benefit from having all editors of all POV's contributing, those with minority POVs often struggle at accept that their take on the issue is not afforded equal weight on Wikipedia. That does seem unfair and to some extent it is unfair - but its how Wikipedia works. So, if largely reflecting the mainstream view is herd mentality, as you put it, then you either have to follow the herd or your are oging to be in for a tough time. However, even if you don't like the fact that the mainstream gets more coverage, you still can put your efforts into making sure the minority views are reflected accurately. Surely that is better than not engaging at all? Rockpocket 04:43, 14 May 2007 (UTC)

text: Then I agree with you. Often editors will treat new editors who are open about their minority views with suspicion, which is very unfortunate and in violation of WP:AGF and WP:BITE. In their defence, it is because we are fighting a continuing battle with people seeing Wikipedia as the perfect place to promote minority views, rather than just record them. Nevertheless, that doesn't excuse the fact that they often drive away those that can help us. The only way we will get the best articles is to have people of all persuasions contribute their knowledge; since misrepresenting minority views is as harmful as promoting them. I can only ask that you do stick it out and don't let those rude people drive you away. Rockpocket 05:20, 14 May 2007 (UTC)
thread_title: very VERY scary

message: Scuro, if you want to lift something from a source you have to either:
1) copy it exactly, put it in quotation marks and put a footnote giving the source.
or
2) put it in your own words with a footnote saying where you got in from, for example,
A recent textbook lists the following important events in the history of ECT:
Task force reports published in ... and ....
Articles on the electrode placement published in .... ....
etc etc and then, at the end, put a reference (in this case to Rudorfer).
Just changing the occasional word, for example, "encouraged" to "recommended" isn't enough. —The preceding unsigned comment was added by Staug73 (talk • contribs) 13:31, 7 May 2007 (UTC)
thread_title:  Plagiarism 

message: Once again we have ipov tags taken off without any sort of consensus. This time the tags were placed on sections with detailed notes in discussion that listed exact points of bias. While it is fine that editors edit the section to bring the section to a more neutrel point of view, that doesn't mean the edit is acceptable to the community of editors or even to the editor who placed the IPOV tag originally. You have to ask.
Good faith would mean possibly making the edits while leaving the tag on and then explaining the edits and seeking concensus in discussion. Or if it is a contentious issue, illlustrating the edits first in discussion seeking consensus and then editing and removing the tag. Unilaterial action is neither a good faith action nor does it build consensus. --scuro 16:43, 7 May 2007 (UTC)
thread_title: and that's the problem

message: The history section has now also been obliterated by Staug73 with no input either previously or after the deletion in discussion. Only the title is left. Considerable time was taken in creating this section.--scuro 17:01, 7 May 2007 (UTC)
thread_title: The history section no longer meets wiki standards

message: I have taken out most of the history, which will go into history section (so please leave history section alone for time being). I may have lost some footnotes etc and one or two sections need a bit of work. I will look at them tomorrow. Took out mechanism of action as it was causing so many problems! A question for any Americans - should it be "in the US" or "in the USA"?Staug73 17:40, 8 May 2007 (UTC)
replies: text: Staug, I've removed the history section simply because there's no content in it yet.  Please add the heading when writing the section itself.  Thanks.--Loodog 03:00, 9 May 2007 (UTC)
thread_title:  Removing history 

message: Have you recently noticed about 1/2 dozen major subsections deleted or left with a sentence that ends like this, "..treatment in which seizures are induced with electricity". Furthermore have you noticed that Staug73 seems to think he owns all or part of this article? ((Electroconvulsive therapy‎; 17:29 (+14)Staug73 (Talk | contribs) (→The History of ECT - Hands off - this is MY section (for the history taken out of rest of article)) 
I can't contribute recently without being deleted. I can't post IPOV tags even after I make my case in discussion because they get deleted. I can't function as an editor. EVERY other Wikipedian I have encountered, even the most ardent ones have abided by basic Wikipedian rules and principles. This is verging on anarchy and I wonder why we tolerate it as a community. --scuro 02:48, 9 May 2007 (UTC)
replies: text: This article is a pale shadow of its former glory. The old one wasnt necessarily perfect, but it was way more interesting. I move that it is reverted. does anyone second? --popefauvexxiii 09:42, 17 May 2007 (UTC)
replies: text: No, as "glorious and interesting" as it may have been, it was and still is biased.--scuro 10:37, 17 May 2007 (UTC)
replies: text: I don't know, Popefauvexxiii. Which "old" version were you referring to? I agree about it becoming duller.Staug73 13:58, 17 May 2007 (UTC)
thread_title: the deconstruction of this article courtesy of Staug73

message: Please remove the spoiler warning after protection expires. This is supposed to be a serious article. Kusma (talk) 18:49, 15 May 2007 (UTC)
thread_title:  Spoiler warning 

message: I gotta say that citations from 1973 even into the early 80's doesn't cut it in the mental health field. That information is historical. For instance we have the Consensus Development Conference Statement on ECT used as one of the main external links even though I believe there was another consensus statement later. Regardless, this is the disclaimer posted on the link:
"This statement is more than five years old and is provided solely for historical purposes. Due to the cumulative nature of medical research, new knowledge has inevitably accumulated in this subject area in the time since the statement was initially prepared. Thus some of the material is likely to be out of date, and at worst simply wrong. For reliable, current information on this and other health topics, we recommend consulting the National Institutes of Health's MedlinePlus http://www.nlm.nih.gov/medlineplus/". —Preceding unsigned comment added by Scuro (talk • contribs) 
:Without wishing to be difficult, I'm not sure I agree. To my mind, if there were valid studies from the 70s and 80s which actually demonstrated brain damage, they should be included - so for example, I think the Colon & Notermans study () should be included, because it did demonstrate a loss of nuclear volume. However, it absolutely should not be used to support the statement "ECT causes brain damage" unless another citation can be found illustrating that a loss of nuclear volume in brain cells without death of neurons is brain damage.
:The only exceptions should be where the older studies are smaller, less well-designed, or have been superseded by more recent research. For instance, a number of the ones cited above are retrospective reviews of notes, and those are clearly less valuable than prospective work (per evidence-based medicine and the criteria given there for stratifying medical evidence).
:As I say, not trying to pick fights - but I don't think we should exclude research purely because of when it was done. Nmg20 14:09, 18 May 2007 (UTC)
replies: text: Absolutely agree with that, Scuro. The article should represent the current consensus opinion based on the best research out there, and if a single study contradicts that, there needs to be a compelling reason to put it in the article - for instance, unless a loss of nuclear volume can be shown to be relevant to e.g. memory loss or cognitive dysfunction, I'd be tempted to exclude Colon & Notermans completely - except that including them under a "While some studies have found brain changes after ECT (references), none have demonstrated that these were caused by the treatment, and large-scale, prospective review studies have found that it doesn't cause brain damage (references)" might stop the same studies getting posted here every couple of months. Nmg20 11:25, 20 May 2007 (UTC)

text: Assume from your comment below that you're "in reluctant, partial agreement" with my assessment of this & the Colon & Notermans article that you've found my assessment of it. Do let me know if not. Nmg20 20:17, 21 May 2007 (UTC)
thread_title: rehashed OLD references

message: Would anyone be able to add anything about other countries, for example, Australia, Canada (or anywhere else) to the current use section? It is looking a bit bare with just the US and UK and only a mention of a few other countries.Staug73 15:05, 22 May 2007 (UTC)
replies: text: True, wikipedia tends to be overly United States centered, especialy here.  All countries mentioned so far are: US, UK, and a bunch of countries where it has a history in flagrant human rights violations.--Loodog 15:59, 22 May 2007 (UTC)
thread_title:  Anyone from Australia, Canada.....? 

message: This section from the brain damage discussion subsection seems to have been removed by you, "all of the recent scientific reviews on topic have concluded that there is no evidence that ECT causes brain damage". Any comment? 
*This was the recorded edit: Revision as of 13:55, May 23, 2007 (edit)Staug73 (Talk | contribs)
--scuro 16:18, 23 May 2007 (UTC)
thread_title: Staug73, are you deleting info from discussion?

message: An upside to all this discussion/borderline flaming is that article is getting editing attention as well as accruing sources in the process.  If we can all stop trying to convince each other on the morality of ECT, the article might be able to pass a good article review.--Loodog 20:25, 23 May 2007 (UTC)
replies: text: Ahhh...finding the silver lining in every situation. I agree. =) Jumping cheese Cont@ct 22:25, 23 May 2007 (UTC)
replies: text: Upside...I never thought I would get THAT familiar with Wikipedia's five pillars.--scuro 02:13, 24 May 2007 (UTC)
thread_title:  The upside 

message: What is disturbing in reading some of the literature is that not all countries use the most up to date methods and technology. There should be a section which spells out the evolution of the procedure and what is considered best practices currently. You get tidbits of info here and there in the article.--scuro 03:02, 25 May 2007 (UTC)
thread_title: different types of ECT machines and treatments

message: What was the point of the mediation cabal that you requested when editors can't follow the explict directions of the mediator:
*What I've been seeing is that it's not an information dispute, but an talking dispute. For this to work, editors must discuss changes before taking action on them. Staug73, you need to discuss what and why you would make a changed before you make it. It's hard to assume good faith when other editors believe that you are, for a lack of a better word, "hurting" the article. Also please remember that the articles and sections are WP:NOTYOURS even if you contribute a good deal to it.  Jac roe 21:15, 15 May 2007 (UTC)
thread_title: Staug73, what was the point of the mediation cabal that you requested?

message: I have done a cut and paste version of this section using the predelete MofA  and the current threshold section. Anyone have an opinion?
Mechanism of action
The aim of ECT is to induce a tonic clonic seizure (a seizure where the person loses consciousness and has convulsions) lasting for at least 15 seconds. A seizure is thought to be a "necessary but not sufficient" condition for successful treatment with ECT, so stimulus levels in excess of an individual's seizure threshold are recommended: about one and a half times seizure threshold for bilateral ECT and up to 12 times for unilateral ECT. Below these levels treatment may not be effective in spite of a seizure, while doses massively above threshold level, especially with bilateral ECT, expose patients to the risk of more severe cognitive impairment without additional therapeutic gains.Seizure threshold is determined by trial and error ("dose titration"). Some psychiatrists use dose titration, some still use "fixed dose" (that is, all patients are given the same dose) and others compromise by roughly estimating a patient's threshold according to age and sex. Older men tend to have higher thresholds than younger women, but it is not a hard and fast rule, and other factors, for example drugs, affect seizure threshold. A vast amount of research has been carried out, much of it on rodents, the exact mechanism of action of ECT remains elusive. A recent textbookRudorfer, MV, Henry, ME, Sackeim, HA (2003). "Electroconvulsive therapy". In A Tasman, J Kay, JA Lieberman (eds) Psychiatry, Second Edition. Chichester: John Wiley & Sons Ltd, 1865-1901. summarises the reasons for this: the difficulty of isolating the therapeutic effect from the plethora of effects that accompany the anesthetic, electric shock and seizure; the differences between human and animal brains; and the lack of satisfactory animal models of mental illness. 
--scuro 22:41, 29 May 2007 (UTC)
thread_title: Mechanism of action -putting this section back in?

message: First off I believe these sections should be merged because memory loss is a primary symptom of ECT. Any current research not covered in a major review or primary source such as the SG webpage could be inserted directly in this section. Far too much of both of the  sections rely on single studies to draw conclusions. That should be changed. There is also a lot of ground to cover here that isn't covered in either section. To start off with I have combined the sections starting with a brief intro. This section should start with the most common side effects and then go to more serious side effects. Then it should go to current research(sackeim), and then the possible difficulty of measuring all side effects. Below is a very rough 1st draft. Please feel free to liberally edit and add to it. 
Side effects-version 2
The physical risks of ECT are similar to those of brief general anesthesia; the United States' Surgeon General's report says that there are "no absolute health contraindications" to its use. Immediately following treatment side effects such as headaches, confusion, and memory loss are common. These primary symptoms are often transient and dependent on many variables. Usually after weeks or months memory difficulties subside. Electrode placement and the way the electricity is manipulated significantly influences the outcome of treatment.  Memory loss and confusion are more pronounced with bilateral electrode placement rather than unilateral, and with sine-wave rather than brief-pulse currents. It is more common that those with persistent losses have gotten bilateral ECT treatment.Benbow, SM (2004) "Adverse effects of ECT". In AIF Scott (ed.) The ECT Handbook, second edition. London: The Royal College of Psychiatrists, 170-174. These conclusions were supported by a recent (2007) large study by Harold Sackeim and colleagues found that the methodology of certain forms of ECT routinely causes adverse cognitive effects, including cognitive dysfunction and memory loss, that can persist for an extended period.FDA, Docket #82P-0316including an IQ loss of more than 30 points in one.See for example, Andre, L (2001). Testimony at the public hearing of the NY State (US) Assembly Standing Committee on Mental Health on electroconvulsive therapy; Donahue, A (12 March 1999). Testimony at the public hearing of the Vermont (US) Health and Welfare Committee on electroconvulsive therapy. 
A challenge for researchers has been to determine the extent of impairment before treatment begins and then compare it to the degree impairment after treatment. Some researchers have questioned if standardized tests such as the Wechsler are sufficiently sensitive to minimal memory loss.Abrams, R (1988). Electroconvulsive therapy. Oxford: Oxford University Press, 136. In the late 1940s American psychologist Irving Janis tested ECT patients by asking them extensive and detailed questions about their lives and found that memory for autobiographical material remained impaired months after ECT.Squire, L (1981). "Retrograde amnesia and bilateral electroconvulsive therapy:long-term follow up". Archives of General Psychiatry 38:89-95.  It was only in the 1970s that the work of Janis was taken up by another American psychologist, Larry Squire. Squire found that on some tests of memory a small group of patients who received bilateral ECT could perform as well seven months after treatment as they had before treatment. However, he was able to demonstrate lasting impairment of memory for events that had occurred in the two years before treatment. In addition, half of the patients had lost more remote memories, and sometimes had no recollection of them even when reminded.. More recently American psychiatrist Sarah Lisanby and colleagues found that bilateral ECT left patients with persistent impairment for memory of public events.Lisanby, SH (2000). "The effects of electroconvulsive therapy on memory of autobiographical and public events". Archives of General Psychiatry 57:581-90.
A recent article by a neuropsychologist and a psychiatrist in Dublin suggests that ECT patients who experience cognitive problems following ECT should be offered some form of cognitive rehabilitation. The authors say that the failure to attempt to rehabilitate patients may be partly responsible for the negative public image of ECT.Mangaoang, MA and Lacey, JV (2007). "Cognitive rehabilitation: assessment and treatment of persistent memory impairments following ECT". Advances in Psychiatry 13: 90-100.
About a 1/2 hour of editing went into that first paragraph. I'm trying to keep former material in while balancing the article and avoiding bias with undo weight or personal anecdotal information. More edits to come. --scuro 05:25, 3 June 2007 (UTC)
replies: text: Again, please don't be in a rush with this. The English sounds a bit odd in places, for example I think it would be better to call memory loss etc effects of treatment rather than primary symptoms. I will have a look at it later.Staug73 14:27, 3 June 2007 (UTC)
replies: text: It has been over a month since I have started working on this page. It took a mammoth effort which included the mediation cabal to get the brain damage section to state the obvious. This one paragraph is the only significant addition to the article that I have been allowed to make. Having said all that, I believe the side effects section could take several more significant edits for it to be comprehensive and accurate. Still, wording is not a reason to hold up editing, see WP:EP. For instance you could make a case that the word, "primary" isn't the best word to use. You could be right or wrong in your assumption. That word conveys a meaning that is lost as soon as you use the phrase, "effects of treatment". There are many possible effects to a treatment of ECT such as vomiting but vomiting is not the most common symptom or the major symptom of ECT treatment. To wait for the wording and phrasing to be perfect in each possible addition doesn't follow Wiki policy. Such editing can be done right on the page as long as material isn't also deleted. As soon as the content is good it should go on the page because it will replace a skeletal section, a section with bias, and or a section that is is missing pockets of information that can be vital to the understanding of a subject. Bottom line, no one should have to wait a month to add a paragraph of excellently cited material. If the content is good it goes on the page. --scuro 15:31, 3 June 2007 (UTC)

text: I have put in a reference to the Lisanby et al study to illustrate concern about memory. See the first paragraph of the study.Staug73 14:37, 4 June 2007 (UTC)
replies: text: Edits made on article as suggested in "article structure" section. This edit was done more to join ideas and sections together to give it a better flow.--scuro 05:45, 9 June 2007 (UTC)
thread_title: help needed with side effects section and research into memory loss

message: Okay, if nobody wants to do the "Ethical Issues" section I proposed, how about adding an internal link to the Wikipedia article "Medical ethics"? This probably should go in the controversy section and, since that section is presently in another article, that linked article would be an appropriate place for an internal link to the article on medical ethics. (I didn't put this note on the controversy article's talk page because that article looks unstable.) The only other appropriate place I presently see would be the "See Also" section, but that section links to the controversy article anyway. The reason for a link to the "Medical ethics" article would be to give the article at least a small mention of ethical conditions, instead of effects alone.
Chris Dubey 00:46, 6 June 2007 (UTC)
replies: text: I think an "ethical issues" section's a great idea - I don't have time myself to research it and put it in the article, but (if people like my proposed structure above), it would probably fit best in section 8 (role in culture)? Nmg20 14:32, 6 June 2007 (UTC)
replies: text: An ethical issues section should include "informed consent" and the "involuntary ECT" subsections that are already in the article. Those sections should be merged into such a section (see article structure discussion). If it gets deep such as philosophical issues, brief mention could be made in the article and then it should link to another article for further info. --scuro 16:31, 6 June 2007 (UTC)

text:  The proposed structure seems fine to me. And I agree that ethical issues would fit well in a section on role in culture. So, I approve. Thanks for the comment. (Chris Dubey 16:50, 6 June 2007 (UTC)
thread_title:  Medical ethics 

message: None of the people cited in this section have citations which support that they have had ECT. When clicking the internal links a number of the articles don't mention ECT. Should these names not have citations to support the claims?--scuro 22:26, 9 June 2007 (UTC)
thread_title: Famous people who have undergone ECT

message: As I read more about side effects there are four possible treatment scenarios using sine vrs. brief and bilateral vrs. unilateral. It seems that the four possible treatment methods are all treated equally or lumped together when in fact sine wave has been discouraged by the APA since 2001 because of the notable difference in long term effects/permanent effects. I believe the conclusions drawn in the article should be "weeded out" more and blanket observations discouraged. Sackheim's recent study has a lot of information on this topic.--scuro 20:48, 11 June 2007 (UTC)
replies: text: That sounds good - I think we're getting to the stage where you could make the changes to the article and then discuss them on here if needed? Nmg20 21:58, 11 June 2007 (UTC)
replies: text: Will do so unless I hear objections. I'll be adding info not already mentioned and eliminating older off base conclusions drawn from single studies. I'll be relying more on reviews, textbooks, and Sackheim for this section. Sackheim's recent study adds new knowledge. By the way, I can't access the one reference to the rare side effect of delerium. Anyone know more about this or can point me in the right direction?--scuro 23:11, 11 June 2007 (UTC)
thread_title: adverse effects

message: I'd like to archive some of the talk page discussion to a "POV dispute" archive where we can store all future similar discussions. Would anyone like me to leave the recent discussions up here a little longer, or can I go ahead and do this? Nmg20 10:48, 12 June 2007 (UTC)
thread_title:  Archiving recent POV discussion