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전기경련치료에 대한 정신건강의학과 의료진의 인식 및 태도 조사

A Survey of Knowledge and Attitudes Towards Electroconvulsive Therapy in Psychiatrists

  • 강석기 (동국대학교일산병원 정신건강의학과) ;
  • 장진혁 (서울알로하 정신건강의학과) ;
  • 안은숙 (용인정신병원 정신건강의학과) ;
  • 이남영 (동국대학교일산병원 정신건강의학과) ;
  • 김세현 (서울대학교병원 정신건강의학과) ;
  • 김용식 (노원을지대학교병원 정신건강의학과, 의정부을지대학교병원 정신건강의학과) ;
  • 정인원 (용인정신병원 정신건강의학과)
  • Suk Key Kang (Department of Psychiatry, Dongguk University Ilsan Hospital) ;
  • Jin Hyeok Jang (Seoulaloha Mental Health Clinic) ;
  • Eunsoog An (Department of Psychiatry, Yong-In Mental Hospital) ;
  • Nam Young Lee (Department of Psychiatry, Dongguk University Ilsan Hospital) ;
  • Se Hyun Kim (Department of Psychiatry, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Yong Sik Kim (Department of Psychiatry, Nowon Eulji Medical Center, Uijeongbu Eulji Medical Center, Eulji University) ;
  • In Won Chung (Department of Psychiatry, Yong-In Mental Hospital)
  • 투고 : 2023.07.01
  • 심사 : 2023.07.25
  • 발행 : 2023.10.31

초록

Objectives This study explores knowledge of and attitudes toward electroconvulsive therapy (ECT) among psychiatrists in Korea. Methods We emailed questionnaires to psychiatrists to assess their knowledge of and attitudes toward ECT. The present analysis focuses on responses to Lutchman's questionnaire. ResultsZZA total of 293 psychiatrists (260 specialists and 33 residents) responded to the questionnaire. The responses showed positive attitudes towards ECT, with an average approval rating of 77.68%. There were no differences between genders, or between specialists and residents, in knowledge of and attitudes toward ECT. However, psychiatrists generally reported insufficient knowledge and/or negative attitudes toward techniques, methods, side effects, and other factors related to clinical implementation of ECT, as well as a lack of clinical experience. In addition, responses were influenced by personal views. Conclusions We assume that insufficient knowledge, lack of experience with the advanced technologies and methods of modern ECT, and negative perceptions of side effects limit the use of ECT for treating mental disorders. Further research aimed at improving knowledge of and attitudes toward ECT among psychiatrists is needed to enhance therapeutic efficacy in the treatment of mental disorders.

키워드

과제정보

This research was supported by a grant of the Korea Mental Health R&D Project, funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HL19C-0051-010019) and partly supported by the research fund of the Yong-In Institute of Psychiatry affiliated with the Yong-In Hospital Maintenance Foundation, a medical corporation.

참고문헌

  1. Oji C, Moore TA, Gutierrez CA. A review of electroconvulsive therapy in suicidality. Ment Health Clin 2015;5:212-215.  https://doi.org/10.9740/mhc.2015.09.212
  2. Joo EJ, Kim HC, Jeong SH, Park SH, Lee NY, Choi YS, et al. Satisfaction survey of patients toward electroconvulsive therapy. J Korean Neuropsychiatr Assoc 2021;60:135-142.  https://doi.org/10.4306/jknpa.2021.60.2.135
  3. Brender R, Dar N, Dannon P. Electroconvulsive therapy: relating attitude towards treatment and knowledge among mental health professionals in a mental health center. Isr J Psychiatry 2018;55:40-45. 
  4. Griffiths C, O'Neill-Kerr A. Patients', carers', and the public's perspectives on electroconvulsive therapy. Front Psychiatry 2019;10:304. 
  5. Jeong WJ, Byoun WT. Survey on the use of ECT in Korean psychiatrists. J Korean Neuropsychiatr Assoc 1983;22:573-581. 
  6. Kim KT, Yoon DJ, Shin YH, Bahn GH, Yum TH. A view of Korean psychiatrists about electroconvulsive therapy. J Korean Neuropsychiatr Assoc 2001;40:1072-1089. 
  7. Kring IS, Bergholt MD, Midtgaard J. The perspectives of former recipients and experts on stigmatization related to electroconvulsive therapy in Denmark: a focus group study. J Psychiatr Ment Health Nurs 2018;25:358-367.  https://doi.org/10.1111/jpm.12470
  8. Lee JH, Kim MA, Kim SH, Lee YS, Kwon JS. Social stigmata of electroconvulsive therapy and their reduction strategies. Korean J Biol Psychiatry 2020;27:37-41. 
  9. Guideline.or.kr [homepage on the Internet]. Seoul: Korea Medical Guideline Information Center [updated 2008; cited 2023 Jun 13]. Available from: https://www.guideline.or.kr/guide/view.php?number=15&cate=B. 
  10. Guideline.or.kr [homepage on the Internet]. Seoul: Korea Medical Guideline Information Center [updated 2020 Nov 24; cited 2023 Jun 21]. Available from: https://www.guideline.or.kr/guide/view.php?number=1123&cate=A. 
  11. Mohw.go.kr [homepage on the Internet]. Sejong; Ministry of Health and Welfare [updated 2022 Jul 1; cited 2023 Jun 14]. Available from: http://www.mohw.go.kr/upload/viewer/skin/doc.html?fn=1656640707192_20220701105827.hwp&rs=/upload/viewer/result/202310/. 
  12. Moon SJ, Park JH, Kim T, Song JY, Bahn GH. Experience with nonpharmacological therapies during psychiatric residency training. J Korean Assoc Soc Psychiatry 2009;14:18-24. 
  13. Seo JS, Bahk WM, Wang HR, Woo YS, Park YM, Jeong JH, et al. Korean medication algorithm for depressive disorders 2017: third revision. Clin Psychopharmacol Neurosci 2018;16:67-87.  https://doi.org/10.9758/cpn.2018.16.1.67
  14. Lee JS, Yun JY, Kang SH, Lee SJ, Choi JH, Nam B, et al. Korean medication algorithm for schizophrenia 2019, second revision: treatment of psychotic symptoms. Clin Psychopharmacol Neurosci 2020;18:386-394.  https://doi.org/10.9758/cpn.2020.18.3.386
  15. Mhlw.go.jp [homepage on the Internet]. Tokyo: Minister of Health, Labour and Welfare [cited 2022 Apr 25]. Available from: https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000177182.html. 
  16. Hirata R, Kawashima H, Tsuboi T, Wada K, Takebayashi M, Suwa T. An online survey about electroconvulsive therapy in Japan during the COVID-19 pandemic: comparison of early and recent stages. Neuropsychiatr Dis Treat 2022;18:1277-1285.  https://doi.org/10.2147/NDT.S365417
  17. Luccarelli J, Henry ME, Smith F, Beach SR, McCoy TH Jr. Changes in inpatient electroconvulsive therapy utilization between 2019 and 2020: a national inpatient sample analysis. J ECT 2023;39:173-178.  https://doi.org/10.1097/YCT.0000000000000917
  18. Opendata.hira.or.kr [homepage on the Internet]. Wonju: Health Insurance Review & Assessment Service [cited 2023 Jun 21]. Available from: https://opendata.hira.or.kr/op/opc/olapDiagBhvInfoTab1.do. 
  19. Folkerts HW, Michael N, Tolle R, Schonauer K, Mucke S, Schulze-Monking H. Electroconvulsive therapy vs. paroxetine in treatment-resistant depression -- a randomized study. Acta Psychiatr Scand 1997;96:334-342.  https://doi.org/10.1111/j.1600-0447.1997.tb09926.x
  20. Park MJ, Kim H, Kim EJ, Yook V, Chung IW, Lee SM, et al. Recent updates on electro-convulsive therapy in patients with depression. Psychiatry Investig 2021;18:1-10.  https://doi.org/10.30773/pi.2020.0350
  21. Lee HY, Kang RH, Lee MS. Electroconvulsive therapy in major depressive disorder. Korean J Biol Psychiatry 2008;15:75-82. 
  22. Joo EJ, Kim HC, Kang UG, Lee NY, Park SH, Kim JM, et al. Electroconvulsive therapy for psychiatric disorders in elderly adults. Korean J Biol Psychiatry 2020;27:42-57. 
  23. Choi YM, Jung SW, Kim YT, Kim HC. Clinical effectiveness of electroconvulsive therapy in a university hospital setting. J Korean Neuropsychiatr Assoc 2015;54:330-337.  https://doi.org/10.4306/jknpa.2015.54.3.330
  24. Song TH, Shim JC, Kong BG, Kang JW, Moon JJ, Kim SJ, et al. Electroconvulsive therapy for patients with treatment-resistant schizophrenia patients: a retrospective study. J Korean Neuropsychiatr Assoc 2012;51:271-276.  https://doi.org/10.4306/jknpa.2012.51.5.271
  25. Small JG. Efficacy of electroconvulsive therapy in schizophrenia, mania, and other disorders. I. Schizophrenia. Convuls Ther 1985;1:263-270. 
  26. Mankad MV, Beyer JL, Weiner RD, Krystal AD. Clinical manual of electroconvulsive therapy. Arlington, VA: American Psychiatric Publishing;2010. 
  27. Kaster TS, Daskalakis ZJ, Blumberger DM. Clinical effectiveness and cognitive impact of electroconvulsive therapy for schizophrenia: a large retrospective study. J Clin Psychiatry 2017;78:e383-e389.  https://doi.org/10.4088/JCP.16m10686
  28. Stenmark L, Popiolek K, Boden R, Brus O, Hammar A, Landen M, et al. Predictors of treatment response to electroconvulsive therapy in schizophrenia-A nationwide registry-based study. Schizophr Bull Open 2020;1:sgaa019. 
  29. Janicak PG, Mask J, Trimakas KA, Gibbons R. ECT: an assessment of mental health professionals' knowledge and attitudes. J Clin Psychiatry 1985;46:262-266. 
  30. Agarwal AK, Andrade C. Indian psychiatrists' attitudes towards electroconvulsive therapy. Indian J Psychiatry 1997;39:54-60. 
  31. Lutchman RD, Stevens T, Bashir A, Orrell M. Mental health professionals' attitudes towards and knowledge of electroconvulsive therapy. J Ment Health 2001;10:141-150.  https://doi.org/10.1080/09638230124779
  32. Kitay B, Martin A, Chilton J, Amsalem D, Duvivier R, Goldenberg M. Electroconvulsive therapy: a video-based educational resource using standardized patients. Acad Psychiatry 2020;44:531-537.  https://doi.org/10.1007/s40596-020-01292-z
  33. Antosik-Wojcinska A, Gazdag G, Swiecicki L, Majtczak B, Rybakowski J, Gosek P, et al. Attitudes towards ECT: a survey of Polish mental health professionals. Psychiatr Danub 2021;33:328-333.  https://doi.org/10.24869/psyd.2021.328
  34. Cabrera LY, Nowak GR 3rd, McCright AM, Achtyes E, Bluhm R. Last resort interventions?: a qualitative study of psychiatrists' experience with and views on psychiatric electroceutical interventions. Psychiatr Q 2021;92:419-430.  https://doi.org/10.1007/s11126-020-09819-1
  35. Chanpattana W. ECT knowledge in psychiatrists, psychiatry residents, and medical students: effect of training. J Med Assoc Thai 1999;82:819-825. 
  36. Ezeobele IE, Ekwemalor CC, Pinjari OF, Boudouin GA, Rode SK, Maree E, et al. Current knowledge and attitudes of psychiatric nurses toward electroconvulsive therapy. Perspect Psychiatr Care 2022;58:1967-1972.  https://doi.org/10.1111/ppc.13016
  37. Leiknes KA, Jarosh-von Schweder L, Hoie B. Contemporary use and practice of electroconvulsive therapy worldwide. Brain Behav 2012;2:283-344.  https://doi.org/10.1002/brb3.37
  38. Palinska D, Gazdag G, Sobow T, Hese RT, Kloszewska I. [Electroconvulsive therapy in Poland in 2005--a nationwide questionnaire study performed in Polish psychiatric clinics]. Psychiatr Pol 2008;42:825-839. Polish 
  39. Finch JM, Sobin PB, Carmody TJ, DeWitt AP, Shiwach RS. A survey of psychiatrists' attitudes toward electroconvulsive therapy. Psychiatr Serv 1999;50:264-265.  https://doi.org/10.1176/ps.50.2.264
  40. Gazdag G, Kocsis N, Tolna J, Lipcsey A. Attitudes towards electroconvulsive therapy among Hungarian psychiatrists. J ECT 2004;20:204-207.  https://doi.org/10.1097/00124509-200412000-00003
  41. Gazdag G, Zsargo E, Kerti KM, Grecu IG. Attitudes toward electroconvulsive therapy in Romanian psychiatrists. J ECT 2011;27:e55-e56.  https://doi.org/10.1097/YCT.0b013e318214c576
  42. Golenkov A, Ungvari GS, Gazdag G. ECT practice and psychiatrists' attitudes towards ECT in the Chuvash Republic of the Russian Federation. Eur Psychiatry 2010;25:126-128.  https://doi.org/10.1016/j.eurpsy.2009.02.011
  43. Lauber C, Nordt C, Falcato L, Rossler W. Can a seizure help? The public's attitude toward electroconvulsive therapy. Psychiatry Res 2005;134:205-209.  https://doi.org/10.1016/j.psychres.2004.07.010
  44. Fink M, Taylor MA. Electroconvulsive therapy: evidence and challenges. JAMA 2007;298:330-332.  https://doi.org/10.1001/jama.298.3.330
  45. Chung IW, Kang UG, Kang TU, Kim SH, Kim YN, Kim HC, et al. Korean version of guideline for electroconvulsive therapy. Seoul: National Center for Mental Health;2021. 
  46. Chakrabarti S, Grover S, Rajagopal R. Electroconvulsive therapy: a review of knowledge, experience and attitudes of patients concerning the treatment. World J Biol Psychiatry 2010;11:525-537. https://doi.org/10.3109/15622970903559925