Emil Kraepelin diagnosed the paranoid, catatonic, and hebephrenic forms of dementia praecox, a disease he created.

In my view, Dr Angell’s assertions reflect both a serious misunderstanding of psychiatric diagnosis, and—equally important—a failure to address the core philosophical issues involved in her use of the terms “subjective,” “objective,” “behaviors,” and “signs.”

ECT, like abortion, is surrounded by controversy and strong opinions on both sides. Fortunately, for those of us who practice ECT, the discussion is not quite as heated nor the risks as high as for our colleagues in ob-gyn.