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Read Original Story

In a new book, Kitty Dukakis credits electroconvulsive therapy for relieving her famously disabling depression

Rating

3 Star

In a new book, Kitty Dukakis credits electroconvulsive therapy for relieving her famously disabling depression

Our Review Summary

The article describes one person’s experiences–a famous person’s experiences–with electroshock therapy for severe depression. Although her story is compelling and interesting, anecdotal story-telling is fraught with potential bias. The information is based on one person’s experiences without any objective or independent information. However, readers do get a sense of the natural history or burden of severe depression, which can be quite disabling. Readers also get a sense that treatment worked for this woman (her anecdotal experience would support the benefit reported in the scientific literature). However, because the story is anecdotal, the evidence that this treatment actually works is not provided, nor any information about whom it helps, in what situations, by how much, or for how long. Readers can also get a sense of disadvantages or harms of treatment, namely memory problems in this story. However, the story could be improved by actually reporting published harms of treatment and providing readers with estimates for how often these might occur.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The article does not mention costs of treatment.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story does not describe benefits in quantitative terms, although the story describes qualitative experiences anecdotally. There is no description of whom this might benefit or under what circumstances (those for whom other treatments have failed or for whom an immediate response is required) or by how much one might improve or for how long.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The article describes memory problems as a harm of treatment, which are well-described, but without any quantitative context. The reader is not able to assess their relative importance. Another disadvantage of ECT is that effects are short-term, which could be deduced from the number of treatments reported anecdotally, although this was not explicit. Antidepressants are usually needed after ECT treatment, which may not be viewed as a typical harm of treatment, but this is not really described, and in fact, the anecdotal story makes it sound like the story-teller was able to stop antidepressants altogether (while this may be true, it may not have occurred right away). The list of harms could be longer and they include the risks of general anesthesia and death.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The article does not describe any scientific evidence for use of ECT (for which there is good evidence of a benefit in selected people). This article would have been enhanced if the compelling personal story had been put into context with information about the treatments provided. There is a broad and cogent literature supporting the use of psychotherapy, medication, and ECT, but the reader of this story would not learn this without independent research.

Does the story commit disease-mongering?

Satisfactory

The personal account, although anecdotal and potentially biasing, does appropriately describe the disabling nature of severe depression. Personal situations and feelings are described, but they are reasonable descriptions of how depression can affect one’s life. And depression is highly prevalent in the general population. One excerpt that is questionable is the statement that this person wasn’t able to grieve over her father’s death until after she stopped antidepressants, implying that antidepressants prevented her from feeling grief, which is misleading. The story describes a treatment-refractory case and many people with depression respond adequately to psychotherapy, medication, or both. But overall, the description of the natural history seems appropriate.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

A major fault of the story is that it is purely anecdotal. It is one person’s experience, which is compelling and probably sells magazines, but maybe not the best range of information. Although this is a confessional, honest, and moving account, it is subjective. Commentary from unbiased experts would be a welcome addition, adding context into which to fit this story.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story describes very briefly one person’s experiences with other treatment options, namely antidepressants and/or depression counseling. For people with severe depression, antidepressants, or antidepressants together with depression counseling are other treatment options, although this is not explicitly stated in the story. It appears that the story-teller tried both of these options at some point or another.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The article states electroshock therapy, or ECT, has been around since the 1930’s and also names an institution where such therapy was provided.

Does the story establish the true novelty of the approach?

Satisfactory

The story states ECT has been around since the 1930’s, so this is not new.

Does the story appear to rely solely or largely on a news release?

Not Applicable

The story doesn’t rely on a news release; it’s an excerpt from a book.

Total Score: 4 of 9 Satisfactory

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