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Consensus on Electroconvulsive Therapy

Carol C. Nadelson, MD
JAMA. 1986;255(15):2023. doi:10.1001/jama.1986.03370150065015.
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To the Editor.—  While the American Psychiatric Association (APA) acknowledges the general value of the Consensus Development Conferences, we wish to convey our concern about the report on electroconvulsive therapy (ECT) that emerged from a recent National Institutes of Health Consensus Development Conference.1The Consensus Panel found that "ECT is demonstrably effective for a narrow range of severe psychiatric disorders," confirming the value of the treatment for some patients with serious mental disorders. However, the ambitious goals of the conference and the process by which consensus was reached have also resulted in compromises that have seriously affected the tone and substance of the report. As a result, some of the published content reflects less than scientific positions on a difficult subject.The APA wishes to point out the following areas:1. Phraseology that describes ECT as "the most controversial treatment in psychiatry," the effects as "toxic," and the systemic


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