{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T02:53:53Z","timestamp":1781319233091,"version":"3.54.1"},"reference-count":63,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2022,2,15]],"date-time":"2022-02-15T00:00:00Z","timestamp":1644883200000},"content-version":"unspecified","delay-in-days":45,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2022]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:p>It is estimated that electroconvulsive therapy is still administered to approximately a million people a year. It involves passing enough electric current through the human brain, eight to twelve times, to cause convulsions, in the hope of somehow alleviating emotional suffering, primarily depression. There have only ever been 11 placebo-controlled studies (where general anaesthesia is administered but the electric shock is withheld), all of which were pre-1986, had very small sample sizes and were seriously methodologically flawed. Five of these studies found no difference between the two groups at the end of treatment, four found ECT produced better outcomes for some patients, and two produced mixed results, including one where psychiatrists' ratings produced a difference, but the ratings of nurses and patients did not. In the 80 years since the first ECT no studies have found any evidence that ECT is better than placebo beyond the end of treatment. Nevertheless, all five meta-analyses relying on these studies have somehow concluded that ECT is more effective than placebo despite the studies' multiple failings. Meanwhile, evidence of persistent or permanent memory loss in 12% to 55% of patients has accumulated. Attempts to highlight this failure of ECT proponents to provide robust evidence that their treatment is effective and safe are routinely dismissed, diminished, denied and denounced. This paper responds to one such attempt, by Drs Meechan, Laws, Young, McLoughlin and Jauhar, to discredit two systematic reviews of the eleven pre-1986 studies, in 2010 and 2019, the latter of which also reviewed five meta-analyses that had ignored the studies' failings. The criticisms and claims of the recent crtiique of the two systematic reviews are examined in detail, by the first author of both reviews, for accuracy, relevance and logic. The critique is found to include multiple errors, misrepresentations, omissions, inconsistencies and logical flaws. It is concluded that Meechan <jats:italic>et al<\/jats:italic>. fail to make a fact-based, coherent argument against suspending ECT pending a series of large, carefully designed placebo-controlled studies to establish whether ECT does have any beneficial effects against which to weigh the significant established adverse effects.<\/jats:p>","DOI":"10.1017\/s2045796021000846","type":"journal-article","created":{"date-parts":[[2022,2,15]],"date-time":"2022-02-15T07:01:27Z","timestamp":1644908487000},"source":"Crossref","is-referenced-by-count":13,"title":["A response to yet another defence of ECT in the absence of robust efficacy and safety evidence"],"prefix":"10.1017","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5159-1192","authenticated-orcid":false,"given":"John","family":"Read","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2022,2,15]]},"reference":[{"key":"S2045796021000846_ref14","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.142.6.610"},{"key":"S2045796021000846_ref21","first-page":"73","article-title":"Subjective memory complaints after electroconvulsive therapy: systematic review","volume":"43","author":"Jones","year":"2019","journal-title":"British Journal of Psychiatry Bulletin"},{"key":"S2045796021000846_ref34","first-page":"21lr14047","article-title":"An evidence-based response to Dr Andrade's commentary on our review of the ECT efficacy research","volume":"82","author":"Read","year":"2021","journal-title":"Journal of Clinical Psychiatry"},{"key":"S2045796021000846_ref39","doi-asserted-by":"publisher","DOI":"10.1017\/S1121189X00000671"},{"key":"S2045796021000846_ref50","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1301180"},{"key":"S2045796021000846_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2007.08.005"},{"key":"S2045796021000846_ref3","first-page":"1","article-title":"Clinical guidelines for the management of treatment-resistant depression: French recommendations from experts, the French association for biological psychiatry and Neuropsychopharmacology and the Fondation FondaMental","volume":"19","author":"Bennabi","year":"2019","journal-title":"BMC Psychiatry"},{"key":"S2045796021000846_ref62","doi-asserted-by":"publisher","DOI":"10.1007\/s10597-021-00913-7"},{"key":"S2045796021000846_ref35","first-page":"292","article-title":"Response to \u2018ECT vs sham ECT for depression: do study limitations invalidate the evidence (and mean we should stop using ECT)?\u2019","volume":"27","author":"Read","year":"2021","journal-title":"British Journal of Psychiatry Advances"},{"key":"S2045796021000846_ref30","first-page":"470985","article-title":"Predictors of time to relapse\/recurrence after electroconvulsive therapy in patients with major depressive disorder: a population-based cohort study","author":"Nordenskjold","year":"2011","journal-title":"Depression Research and Treatment"},{"key":"S2045796021000846_ref55","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.142.1.1"},{"key":"S2045796021000846_ref43","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k5233"},{"key":"S2045796021000846_ref1","first-page":"285","article-title":"Electroconvulsive therapy (ECT) versus sham ECT for depression: do study limitations invalidate the evidence (and mean we should stop using ECT)?","volume":"27","author":"Anderson","year":"2021","journal-title":"British Journal of Psychiatry Advances"},{"key":"S2045796021000846_ref29","volume-title":"Guidance on the Use of Electroconvulsive Therapy","year":"2010"},{"key":"S2045796021000846_ref33","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e3181719b23"},{"key":"S2045796021000846_ref11","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2013.00094"},{"key":"S2045796021000846_ref26","unstructured":"Moore, J (2020) John Read and Irving Kirsch \u2013 Electroconvulsive Therapy (ECT) Does the Evidence From Clinical Trials Justify its Continued Use? Mad in America podcast, June 13. Available at https:\/\/www.madintheuk.com\/2020\/06\/john-read-irving-kirsch-ect-does-evidence-from-trials-justify-its-use\/."},{"key":"S2045796021000846_ref44","doi-asserted-by":"publisher","DOI":"10.1891\/EHPP-D-19-00014"},{"key":"S2045796021000846_ref31","doi-asserted-by":"publisher","DOI":"10.4306\/pi.2015.12.3.417"},{"key":"S2045796021000846_ref19","first-page":"644","article-title":"Naturalistic comparative study of outcome and cognitive effects of unmodified electro-convulsive therapy in schizophrenia, mania and severe depression in Nigeria","volume":"76","author":"Ikeji","year":"1999","journal-title":"East African Medical Journal"},{"key":"S2045796021000846_ref6","article-title":"Comment, August 4, on Vlessides M (2020) Experts call for immediate suspension of ECT, others push back","author":"Brink","year":"2020","journal-title":"Medscape"},{"key":"S2045796021000846_ref25","article-title":"A critique of narrative reviews of the evidence-base for ECT in depression","author":"Meechan","year":"2021","journal-title":"Social Psychiatry and Psychiatric Epidemiology"},{"key":"S2045796021000846_ref18","first-page":"4","article-title":"ECT: an effective and safe treatment","volume":"38","author":"Henry","year":"2021","journal-title":"Psychiatric Times"},{"key":"S2045796021000846_ref28","volume-title":"Guidance on the Use of Electroconvulsive Therapy","year":"2003"},{"key":"S2045796021000846_ref37","article-title":"Why is electroshock therapy still a mainstay of psychiatry?","author":"Read","year":"2021","journal-title":"Aeon"},{"key":"S2045796021000846_ref59","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12705-5"},{"key":"S2045796021000846_ref54","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j4008"},{"key":"S2045796021000846_ref32","volume-title":"Pedler M. 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