Editor's Roundup for Issue #3 of 2022

Abstract

T his issue of the Journal of ECT is packed full of interesting articles, and here we highlight a few of them. The methodology of research into electroconvulsive therapy (ECT) has incrementally improved over the decades with the standardized reporting of stimulus dosing and the addition of more complex cognitive batteries in randomized clinical trials (RCTs). Yet in many fields of medicine, advances in research are made from "big data" and not from RCT. The National Network of Depression Centers now provides recommendations on how to harmonize the documentation of an ECT session, and this will go a long way to allowing the harvesting of "big data" for ECT. 1 ECT research has always grappled with the problems in creating suitable sham ECT sessions for inclusion in RCT, and McManus et al 2 describe a sham for ECT that is workable in patients with neurocognitive disorders. Reducing the intensity of borderline personality traits is a challenge across all aspects of psychiatry, including during the provision of ECT. Luccarelli et al 3 report that the presence of these traits increases the odds of having an ECT course of at least 10 sessions, but with good tolerance. Most of the research into the effects of ECT on cognition has focused on memory and amnestic effects, with much less attention paid to the possible effects on executive function. Garg et al 4 note that executive function is composed of response inhibition, interference control, working memory, and cognitive flexibility. These investigators comprehensively measured executive function in 50 adults before ECT and then 3 and 6 months later. Remarkably, no patient experienced a deterioration in executive function after ECT, and patients actually improved on many dimensions of executive function. These findings should further reassure patients and families. Finally, Zhang et al 5 describe an experiment comparing the cardiovascular response between those patients who received ECT and those who received magnetic seizure therapy. Magnetic seizure therapy was associated with a smaller cardiovascular response, perhaps paralleling its smaller global physiologic impact.