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The effect of structured consent on recall of information pre- and post-electroconvulsive therapy: a pilot study

All Birmingham Psychiatry Rotational Training Scheme

P. Bentham, Consultant in Old Age Psychiatry^*

The Queen Elizabeth Psychiatric Hospital, Edgebaston, Birmingham B15 2QZ;

J. Stemman, Specialist Registrar and V. Staples, Specialist Registrar

West Midlands Higher Training Scheme in Psychiatry

S. Ambegaoker, Senior House Officer, R. Upthegrove, Senior House Officer and E. Day, Senior House Officer

All Birmingham Psychiatry Rotational Training Scheme

^* Correspondence

Aims and method A randomised, blind comparison of a structured consent procedure against routine consent was conducted to determine whether it had any utility in improving treatment knowledge in patients receiving electroconvulsive therapy (ECT). Additionally we aimed to determine whether degree of cognitive impairment, intelligence and severity of depression influenced recall of information.

Results Thirty-two subjects were investigated. Structured consent significantly improved the number of knowledge items recalled pre-ECT (P<0.05). Knowledge scores declined significantly after completion of the treatment course in both structured consent (P<0.05) and control groups (P<0.05). There was a significant correlation between Mini-Mental State Examination (MMSE) scores and the number of knowledge items recalled both pre- (r=0.43, P<0.05) and post-ECT (r=0.53, P<0.01).

Clinical implications Structured consent procedures may be a useful way of improving patient knowledge of ECT and merit further study. Low scores on MMSE should caution clinicians to take particular care when consenting patients to ECT.