A comparative analysis of pre- and post-electroconvulsive therapy drawings

In the general hospital, many look at Electroconvulsive Therapy (ECT) as a medical procedure that does not require the integrated efforts of the multidisciplinary team. If ECT treatment is administered without attention to dynamics and other therapeutic issues in the patient’s life and treatment, it may lead to less than successful long-term results (Silbert, 1986). Developing practical outcome measures and collaboration among members of the treatment team are only briefly mentioned in the literature (Scovern & Kilmann, 1980). Measures to determine the adequate course or “success” of ECT are also lacking. The authors of this study designed this research to test the utility of drawings in assessing mood improvement and cognitive impairment as demonstrated in art samples from pre- and post-ECT. Alloy, et al. (1996) cite studies that indicate approximately 17% of Americans will experience depression at some point in their lives. Hospitalization for depression ranks second only to schizophrenia in frequency. Further, physicians report that 12 to 48% of their patients are suffering from depression at a rate that frequently is more debilitating than chronic medical problems such as arthritis and diabetes. Statistics also point to a progressive pattern in the incidents of depression. Barlow and Durand (1995) refer to an increasing percentage of depression in the general population but especially noted the increased risk in younger Americans. For example, they quote Klermen and Weissman’s that “among Americans born before 1905, only one percent had developed depression by age 75, of those since 1955, six percent had become depressed by age 24” (1995, p. 246). Of course, all depressed people do not end up committing suicide nor do all require last resort measures such as ECT. However, according to Alloy et al. (1996), a conservative estimate is that at least 30,000 people per year commit suicide in America. Although ECT remains controversial, partly because of negative stereotypical views, it continues to present a viable alternative for severely depressed people whose depression has been resistant to standard therapy and psychopharmacological treatments. For some, the benefits of ECT are undeniable when it replaces a life threatening depression with restored hope. This study examined the effect of ECT as reflected by altering both content and quality of drawings. Were there statistically significant changes in the drawings from 25 in-patients who participated in the pre- and post-ECT study? Seven parameters in the art products were measured in pre- and post-ECT drawings. Significant changes appeared between the drawings on two of the parameters. The study demonstrated the value of collaborated efforts from separate departments. Also, the results may be of interest, not only for art therapists and psychiatrists, but to other clinicians, depressed people, family members, artists and the general public may see concrete benefits from the results of this study. The scope of this study was limited in the size and may warrant replication with refinements. Although research in art therapy inevitably poses new questions, its importance cannot be ignored given the incipient stage and needs of the art therapy field. Assessment tools such as this may prove to be a valuable contribution to the field.