Last Resort Interventions?: A Qualitative Study of Psychiatrists’ Experience with and Views on Psychiatric Electroceutical Interventions

Abstract

Psychiatrists play an important role in providing access to psychiatric electrical interventions (PEIs) such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS). As such, their views on these procedures likely influence whether they refer or provide these types of treatments for their clinically depressed patients. Despite this, scholars have too infrequently examined psychiatrists’ views about specific PEIs and have not yet examined their views across different PEIs. To gain insight into psychiatrists’ views about PEIs, we conducted a qualitative study based on semi-structured interviews with 16 psychiatrists in Michigan. The majority of psychiatrists had a positive attitude towards PEIs in general. One-third reported cautionary attitudes towards PEIs; they did not reject the interventions but were skeptical of their effectiveness or felt they needed further development. The majority of psychiatrists consider ECT and TMS to be viable therapies that they would discuss with their patients after several failed medication trials. There was a lack of knowledge about surgical PEIs, such as deep brain stimulation. This study provides insights into how psychiatrists perceive PEIs. While broadly positive attitudes exist, this research highlights certain challenges, particularly lack of knowledge and ambiguity about the use of PEIs.

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Acknowledgments

We further thank our participants for their time and insightful responses. We also thank Marissa Cortright and Emily Castillo for their support in coding the interviews.

Availability of Data and Material

Access to interview data is available upon request.

Code Availability

NA

Funding

This work was supported by the NIH BRAIN-NIMH under Grant number: 1RF1MH117802–01, PI: LC.

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Authors

Contributions

Conceptualization: Laura Y. Cabrera, Robyn Bluhm, Aaron McCright; Methodology: Laura Y. Cabrera, Robyn Bluhm; Formal analysis and investigation: Laura Y. Cabrera, Robyn Bluhm; Writing - original draft preparation: Laura Y. Cabrera, Gerald R. Nowak III (discussion); Writing - review and editing: Robyn Bluhm, Gerald R. Nowak III, Aaron McCright, Eric Achtyes; Funding acquisition: Laura Y. Cabrera; Resources: Eric Achtyes; Supervision: Laura Y. Cabrera, Robyn Bluhm, Aaron McCright.

Corresponding author

Correspondence to L. Y. Cabrera.

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Conflict of Interest

LC, RB, and AM have no conflicts of interest to declare. EA has received research support from the following entities in the preceding 12 months: Alkermes, Astellas, Biogen, Boehringer-Ingelheim, InnateVR, Janssen, National Network of Depression Centers, Neurocrine Biosciences, Novartis, Otsuka, Pear Therapeutics, Takeda, and the Vanguard Research Group. He has also served on advisory boards or consulted with: Alkermes, F. Hoffman-La Roche, Janssen, Otsuka/Lundbeck, and Sunovion.

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Cabrera, L.Y., Nowak, G.R., McCright, A.M. et al. Last Resort Interventions?: A Qualitative Study of Psychiatrists’ Experience with and Views on Psychiatric Electroceutical Interventions. Psychiatr Q 92, 419–430 (2021). https://doi.org/10.1007/s11126-020-09819-1

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Keywords

  • Electroceuticals
  • Depression
  • Electroconvulsive therapy
  • Deep brain stimulation
  • Transcranial magnetic stimulation