In analysing the results of a survey of electro-convulsive therapy (ECT) practice in Metropolitan New York community hospitals in 1997, Prudic et al. (2001) focus their attention on the psychological side-effects of ECT, and in so doing, ignore the reasons why ECT is given.

The report of Prudic and colleagues (2001, 31, pp. 929–934) on the results of a mailed questionnaire survey of ECT practices at a sample of New York City Metropolitan area hospitals is in the best tradition of professional self-evaluation, as exemplified by the influential survey conducted by Pippard & Ellam (1981) in the United Kingdom.

We thank Dr Abrams and Dr Fink for their comments on our article, ‘Electroconvulsive therapy practices in the community’ (Prudic et al. 2001). The major point of our paper was that there was considerable heterogeneity in the nature of ECT practices employed in hospitals in the New York City metropolitan region. Neither Dr Abrams nor Dr Fink disputes this, as the evidence was straight forward.