I refer to the article by Helen Luk headlined, 'A jolt in the medical system' (Sunday Morning Post, September 28). The Hong Kong Psychogeriatric Association is concerned about comments made regarding electroconvulsive therapy (ECT). The article quoted the comments of an American neurologist, in 1977, that ECT would cause brain damage. However, the numerous international literature on the effectiveness and safety of ECT refutes this. There is a consensus among psychiatrists all over the world, including Hong Kong. They believe that ECT is a very effective treatment for depression and certain other categories of mental conditions. Various experts have endorsed the use of ECT and guidelines on ECT are available in the American Psychiatric Association, the Royal College of Psychiatrists of the United Kingdom and the Royal Australian and New Zealand College of Psychiatrists. We feel it is important to reaffirm that ECT is a safe and effective treatment modality in psychiatry. The public has a right to know the truth rather than to be presented with the unfounded opinion given by a neurologist more than 20 years ago. Such views have been disproved by the overwhelming scientific evidence provided over the last two decades. The fact is that scientific studies adopting objective assessments have not shown the presence of long-lasting significant memory impairment. Neither is structural brain damage found as a sequel to ECT. Due appraisal by skilled professionals, of the risks and benefits, is one of the core components of modern medical intervention. Just like the use of a painkiller or removal of a tumour by surgery, treating the agonies of intractable depression or hallucination by ECT is not excepted. The public can be reassured that it is done locally in a closely regulated manner, by highly-skilled professionals under internationally-accredited settings, with the participation of the ECT recipients and their carers. Use of ECT is particularly relevant to elderly people with mental problems. They are more likely to suffer from medial illnesses that render them unsuitable for some psychiatric medications with potential problems to their hearts. There is also evidence that elderly patients respond to this treatment better than younger patients. ECT is an indispensable treatment for elderly people worldwide and many suicidal patients have been saved by the use of ECT. Society needs to be aware that the price paid if ECT was not offered to patients in need of such treatment would be unbearable for the patients, for the carers and for society. For the information of readers, the Hong Kong Psychogeriatric Association consists of a group of mental health professionals working in the field of psychogeriatrics in Hong Kong. Dr W. F. CHAN for External Affairs Committee Hong Kong Psychogeriatric Association
