Attitudes and Knowledge about Electroconvulsive therapy among Individuals with Schizophrenia and their Relatives: the Role of Direct Experience.

Electroconvulsive Therapy (ECT) remains a stigmatized treatment despite its well-established efficacy and safety in various psychiatric conditions. Among individuals with schizophrenia-who already face high levels of illness-related stigma-ECT-related stigma may represent an additional barrier to treatment acceptance. This case-control study aimed to examine how direct experience with ECT, either personally or through a family member, influences knowledge, perceptions, and treatment acceptance among individuals with schizophrenia and their relatives. A total of 200 participants, including 100 individuals with schizophrenia (50 with prior ECT experience and 50 without) and 100 of their relatives, completed standardized assessments measuring cognitive function, symptom severity, internalized stigma, attitudes toward psychiatric medications, and ECT-related knowledge and perceptions. The results showed that patients and relatives with prior ECT experience demonstrated higher levels of knowledge and more positive perceptions of ECT compared to those without such experience. Patients with previous ECT were also more likely to accept future ECT, and this acceptance was associated with more favorable attitudes toward psychiatric medications. While internalized stigma levels did not significantly differ between groups, higher stigma in patients was correlated with more negative beliefs about mental illness among their relatives. These findings suggest that individuals with firsthand ECT experience and their families may serve as effective advocates for reducing stigma and promoting informed decision-making in schizophrenia care.