The cognitive impact of Electroconvulsive Therapy (ECT)

Background

Since its first use in 1938, ECT has been used to treat a number of acute psychiatric disorders, particularly major depression. It is widely considered the most effective antidepressant treatment, with medication resistance its leading indication [1]. However, user and carer organisations still remain sceptical [2] largely because our understanding of short and long-term cognitive impairment is limited.

Materials and methods

A battery of neuropsychological tests and questionnaires were selected to include both objective and subjective memory measures. These tests were conducted on ECT patients, before treatment, after 4 treatments, within the week after the final ECT, at 1 month and 6 months, to measure the short and long-term cognitive impact of ECT.

Results

1. Patients generally self-rated their memory functions as significantly improved after a course of ECT.

2. Delayed recall of paired words and short story were sensitive to the adverse cognitive effects of ECT.

3. Spatial Recognition Memory was impaired after ECT.

4. Personal Semantic and Autobiographical Memory for recent events was significantly impaired by ECT.

5. Memory deficits had generally resolved 1 month after ECT.

Conclusions

Cognitive deficits were detected during and within the week after a course of ECT. These deficits were generally not detected 1 month post ECT; however impairments in autobiographical memory for recent events surrounding ECT remain.