Representation of Topical Corticosteroid Withdrawal and Steroid Phobia on TikTok and YouTube Shorts: A Mixed-Methods Content Analysis.

Electroconvulsive therapy (ECT) involves passing electricity through the brain, under general anesthesia, to cause a generalized, tonic–clonic seizure, typically between six and 12 times, over several weeks. Despite the decline in usage over several decades, about one million people worldwide still receive ECT annually (Leiknes et al., ), predominantly women and older people, including about 2500 in England (Read et al., , ). An international review found large variation between continents, countries and regions in utilization rates and clinical practice (Leiknes et al., ). A subsequent review (Wingralek et al., ) also found huge variation in ECT patients per 100,000 of the population between the highest using countries (United States —51, Belgium—47, Sweden—41 and Australia—38) and the lowest (Germany—2.5, Poland—1.3, Latvia—0.5). Two audits in England found 12‐fold (Read et al., ) and 47‐fold (Read et al., ) differences in rates of usage per population between the lowest and highest using areas. There is also significant regional variation within the United States (Peltzman et al., ). Although initially introduced in 1938 to treat people diagnosed with ‘schizophrenia’, ECT soon became predominantly used for depression, although it is still also used, in smaller numbers, on people diagnosed with ‘schizophrenia’, ‘bipolar disorder’ and ‘catatonia’ (Leiknes et al., ). ECT is often considered a gold standard of care for people who have not responded to other treatments (Goldberg, ). ECT, nevertheless, remains controversial (Funk et al., ; Read, Cunliffe, et al., , ). One meta‐analysis of ECT research found views varying from ‘probably ineffective but certainly causes brain damage… through to those who think it is the most effective treatment in psychiatry and completely safe’ (UK ECT Review Group, , p. 799).