Individual Narratives of Stimulation (ECT and TMS) (INSight)

University of Nottingham

Status: Begins enrollment in 1 month

Conditions: Major Depression

Treatments: Other: There is no intervention in this observation study (qualitative interviews about past treatment experiences)

Study type: Observational

Funder types: Other

Identifiers

NCT07807930

26036

Details and patient eligibility

About

Electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) are two evidence-based treatments for major depressive disorder. Both work by stimulating the brain (a process known as neuromodulation), but they differ markedly in invasiveness. ECT requires a general anaesthetic, whereas TMS is delivered while a person is awake and alert and they can go home immediately afterwards. TMS has been proposed as an alternative to ECT for some people. However, TMS is not as effective as ECT in all cases, is generally slower acting, and remains less widely available.

In Nottingham and Liverpool, we have identified a small number of individuals who have experienced both ECT and TMS across different episodes of depression. One such individual is a lived experience co-researcher on our team. Whilst previous studies have explored experiences of ECT and TMS separately, often using relatively superficial methods, none have examined the perspectives of people who have received both treatments. This study addresses that gap through an in-depth exploration of their experiences.

We will use a narrative inquiry approach that encourages participants to tell the story of their experiences of ECT and TMS in their own words. Eligible participants will be adults who have previously received both treatments for depression. Participation involves four sessions: a structured discussion to map the timeline of their depression and treatments, two in-depth open-ended interview sessions (narrative inquiry), and a follow-up discussion about the researchers' reconstruction of their story. Recruitment will take place through services in Nottingham and Liverpool.

This study will help us understand how patients relate to, and make sense of, ECT and TMS, which contextual factors shape their experiences, and how these treatments fit into broader recovery journeys. The findings will inform development of patient-centred services, support shared decision-making, and promote a compassionate understanding of treatment experiences among healthcare professionals.

Enrollment: 12 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 18 years or older
• Previously received at least one TMS and one ECT session as treatment for major depression
• Conversational in the English language
• Capacity to give informed consent to take part in this study
• Feels fully informed and well enough to be able to share potentially distressing past experiences

Exclusion criteria

• Participants may be excluded at the judgement of the PI if it is felt that the participant is at high risk of significant emotional distress from taking part in the interviews at this time

Trial design

12 participants in 1 patient group

People with lived experience of both ECT and TMS for treating major depression

Treatment:

Other: There is no intervention in this observation study (qualitative interviews about past treatment experiences)