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      The influence of prior awareness on views about psychiatric electroceutical interventions among non-clinician stakeholders

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          Abstract

          Psychiatric electroceutical interventions (PEIs) are emerging interventions in the treatment of depression and other mood disorders. The uptake of PEIs is strongly influenced by public, caregiver, and patient views. This study examines the influence of prior awareness and of trust in the medico-scientific establishment with respect to non-clinicians’ views on PEI among a cohort of U.S. respondents. About 3098 U.S. caregivers, patients, and members of the general public completed an online survey with an embedded experiment to evaluate PEI views by stakeholder, modality, and disease severity. ANOVA statistical tests and logistic regression models were used to identify significant differences between groups and moderating factors. Overall, respondents had greater awareness of antidepressant medication (73–84%) and psychotherapy (68–76%) than of any PEI, and ECT garnered the most prior awareness (29–40%) within each group. Non-clinical respondents most often used websites or social media as information sources, and the least trusted sources included those with notable financial interests. Considering the low awareness level among non-clinicians, the implementation of programs to target and advance awareness levels about the use of PEIs in depression among this population may contribute to reducing negative views around these interventions. Fostering trust in the medico-scientific establishment may also increase public support for PEIs as well as uptake of these treatment modalities.

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          Most cited references51

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          Survey research.

          J Krosnick (1999)
          For the first time in decades, conventional wisdom about survey methodology is being challenged on many fronts. The insights gained can not only help psychologists do their research better but also provide useful insights into the basics of social interaction and cognition. This chapter reviews some of the many recent advances in the literature, including the following: New findings challenge a long-standing prejudice against studies with low response rates; innovative techniques for pretesting questionnaires offer opportunities for improving measurement validity; surprising effects of the verbal labels put on rating scale points have been identified, suggesting optimal approaches to scale labeling; respondents interpret questions on the basis of the norms of everyday conversation, so violations of those conventions introduce error; some measurement error thought to have been attributable to social desirability response bias now appears to be due to other factors instead, thus encouraging different approaches to fixing such problems; and a new theory of satisficing in questionnaire responding offers parsimonious explanations for a range of response patterns long recognized by psychologists and survey researchers but previously not well understood.
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            Comparative efficacy and acceptability of non-surgical brain stimulation for the acute treatment of major depressive episodes in adults: systematic review and network meta-analysis

            Abstract Objective To estimate the comparative clinical efficacy and acceptability of non-surgical brain stimulation for the acute treatment of major depressive episodes in adults. Design Systematic review with pairwise and network meta-analysis. Data sources Electronic search of Embase, PubMed/Medline, and PsycINFO up to 8 May 2018, supplemented by manual searches of bibliographies of several reviews (published between 2009 and 2018) and included trials. Eligibility criteria for selecting studies Clinical trials with random allocation to electroconvulsive therapy (ECT), transcranial magnetic stimulation (repetitive (rTMS), accelerated, priming, deep, and synchronised), theta burst stimulation, magnetic seizure therapy, transcranial direct current stimulation (tDCS), or sham therapy. Main outcome measures Primary outcomes were response (efficacy) and all cause discontinuation (discontinuation of treatment for any reason) (acceptability), presented as odds ratios with 95% confidence intervals. Remission and continuous depression severity scores after treatment were also examined. Results 113 trials (262 treatment arms) that randomised 6750 patients (mean age 47.9 years; 59% women) with major depressive disorder or bipolar depression met the inclusion criteria. The most studied treatment comparisons were high frequency left rTMS and tDCS versus sham therapy, whereas recent treatments remain understudied. The quality of the evidence was typically of low or unclear risk of bias (94 out of 113 trials, 83%) and the precision of summary estimates for treatment effect varied considerably. In network meta-analysis, 10 out of 18 treatment strategies were associated with higher response compared with sham therapy: bitemporal ECT (summary odds ratio 8.91, 95% confidence interval 2.57 to 30.91), high dose right unilateral ECT (7.27, 1.90 to 27.78), priming transcranial magnetic stimulation (6.02, 2.21 to 16.38), magnetic seizure therapy (5.55, 1.06 to 28.99), bilateral rTMS (4.92, 2.93 to 8.25), bilateral theta burst stimulation (4.44, 1.47 to 13.41), low frequency right rTMS (3.65, 2.13 to 6.24), intermittent theta burst stimulation (3.20, 1.45 to 7.08), high frequency left rTMS (3.17, 2.29 to 4.37), and tDCS (2.65, 1.55 to 4.55). Network meta-analytic estimates of active interventions contrasted with another active treatment indicated that bitemporal ECT and high dose right unilateral ECT were associated with increased response. All treatment strategies were at least as acceptable as sham therapy. Conclusions These findings provide evidence for the consideration of non-surgical brain stimulation techniques as alternative or add-on treatments for adults with major depressive episodes. These findings also highlight important research priorities in the specialty of brain stimulation, such as the need for further well designed randomised controlled trials comparing novel treatments, and sham controlled trials investigating magnetic seizure therapy.
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              Patients' perspectives on electroconvulsive therapy: systematic review.

              To ascertain patients' views on the benefits of and possible memory loss from electroconvulsive therapy. Descriptive systematic review. Psychinfo, Medline, Web of Science, and Social Science Citation Index databases, and bibliographies. Articles with patients' views after treatment with electroconvulsive therapy. 26 studies carried out by clinicians and nine reports of work undertaken by patients or with the collaboration of patients were identified; 16 studies investigated the perceived benefit of electroconvulsive therapy and seven met criteria for investigating memory loss. The studies showed heterogeneity. The methods used were associated with levels of perceived benefit. At least one third of patients reported persistent memory loss. The current statement for patients from the Royal College of Psychiatrists that over 80% of patients are satisfied with electroconvulsive therapy and that memory loss is not clinically important is unfounded.
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                Author and article information

                Contributors
                lcabrera@psu.edu
                Journal
                Npj Ment Health Res
                Npj Ment Health Res
                NPJ Mental Health Research
                Nature Publishing Group UK (London )
                2731-4251
                3 May 2023
                3 May 2023
                2023
                : 2
                : 6
                Affiliations
                [1 ]GRID grid.415008.8, ISNI 0000 0004 0429 718X, Pine Rest Christian Mental Health Services, ; Grand Rapids, MI 49548 USA
                [2 ]GRID grid.17088.36, ISNI 0000 0001 2150 1785, Lyman Briggs and Philosophy, , Michigan State University, ; East Lansing, MI 48824 USA
                [3 ]GRID grid.17088.36, ISNI 0000 0001 2150 1785, Division of Psychiatry & Behavioral Medicine, , Michigan State University, ; Grand Rapids, MI 49503 USA
                [4 ]GRID grid.17088.36, ISNI 0000 0001 2150 1785, Sociology, , Michigan State University, ; East Lansing, MI 48824 USA
                [5 ]GRID grid.29857.31, ISNI 0000 0001 2097 4281, Center for Neural Engineering, Department of Engineering Science and Mechanics, , Rock Ethics Institute, and Huck Institute of Life Sciences, Pennsylvania State University, ; University Park, PA 16802 USA
                Author information
                http://orcid.org/0000-0001-8939-1535
                http://orcid.org/0000-0001-6251-5251
                http://orcid.org/0000-0002-6220-7096
                Article
                28
                10.1038/s44184-023-00028-9
                10955864
                6bd3af2c-627f-4b36-8013-ef2a99f4dbd7
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 21 January 2023
                : 18 April 2023
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100000002, National Institutes of Health;
                Award ID: RF1MH117802
                Award ID: RF1MH117802
                Award ID: RF1MH117802
                Award ID: RF1MH117802
                Categories
                Article
                Custom metadata
                © The Author(s) 2023

                society,medical ethics,depression
                society, medical ethics, depression

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