Neuropsychological effects and attitudes in patients following electroconvulsive therapy

Abstract

Abstract:The current study examined the effects of electroconvulsive therapy (ECT) on neuropsychological test performance. Forty-six patients completed brief neuropsychological and psychological testing before and after receiving ECT for the treatment of recalcitrant and severe depression. Neuropsychological testing consisted of the Levin Selective Reminding Test (Levin) and Wechsler Memory Scale-Revised Edition (WMS-R). Self-report measures included the Beck Depression Inventory (BDI), the Short-Term Memory Questionnaire (STMQ), and several other measures of emotional functioning and patient attitudes toward ECT. The mean number of days between pre-ECT and post-ECT testing was 24. T-test revealed a signifi cant decrease in subjective ratings of depression as rated by the BDI, t(45) = 9.82, P Ͻ 0.0001 (Pre-BDI = 27.9 ± 20.2; post-BDI = 13.5 ± 9.7). Objective ratings of memory appeared impaired following treatment, and patients' self-report measures of memory confi rmed this decline. More specifi cally, repeated measures MANOVA [Wilks Lambda F(11,30) = 4.3, p Ͻ 0.001] indicated signifi cant decreases for measures of immediate recognition memory (p Ͻ 0.005), long-term storage (p Ͻ 0.05), delayed prose passage recall (p Ͻ 0.0001), percent retained of prose passages (p Ͻ 0.0001), and percent retained of visual designs (p Ͻ 0.0001). In addition, the number of double mentions on the Levin increased (p Ͻ 0.02). This study suggests that there may be a greater need to discuss the intermittent cognitive risks associated with ECT when obtaining informed consent prior to treatment. Further that self-reports of cognitive diffi culties may persist even when depression has remitted. However, patients may not acknowledge or be aware of changes in their memory functioning, and post-ECT self-reports may not be reliable.

Electroconvulsive therapy hasn’t negative effects on short-term memory function, as assessed using a bedside hand-held device

“…Randomized controlled trials, particularly those involving defined risk groups (most notably geriatric and schizophrenic patients), that address ECT-associated neurocognitive impairment are needed to reproduce our findings. 26 …”

Electroconvulsive Therapy in Children and Adolescents

“…85 One of the central issues surrounding ECT and its use in child and adolescent patients is the uncertainty of cognitive adverse effects. 136 Unfortunately, in most of the available literature, it is either unclear how memory and other cognitive measures were assessed or this was not studied in a systematic fashion, although some studies suggests intermittent cognitive risks. 137 The available literature does not suggest a greater level of cognitive dysfunction in children and adolescents after ECT as compared with other therapeutic options.…”

Severe anorexia nervosa, co-occurring major depressive disorder and electroconvulsive therapy as maintenance treatment: a case report

“…In objective measures retrograde memory loss has been found to disappear 6 months post treatment [ 14 ]. Difficulties with verbal and semantic memory are not the most typical consequences of ECT but some evidence of deteriorating verbal memory following ECT has been reported [ 15 ]. It is possible that in this case impaired cognitive capacity and difficulties with verbal memory were not consequences of mECT but a result of a long-term treatment period on a ward for seriously mentally ill patients (consequences of institutionalization), or they were consequences of MDD, or consequences of malnutrition.…”