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Executive function in treatment-resistant depression before and after electroconvulsive therapy.

Zvezdana Stojanovic1, Sanja Andric2, Ivan Soldatovic3

  • 1a Clinic for Psychiatry , Military Medical Academy , Belgrade , Serbia.

The World Journal of Biological Psychiatry : the Official Journal of the World Federation of Societies of Biological Psychiatry
|April 14, 2016
PubMed
Summary

Electroconvulsive therapy (ECT) for treatment-resistant depression (TRD) does not harm executive functions (EF). Improvements in planning time correlated with reduced depression severity after ECT.

Keywords:
CANTABECTExecutive functionsThe Stockings of Cambridge taskmajor depression

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Cognitive Psychology

Background:

  • Treatment-resistant depression (TRD) often involves cognitive impairments, including executive function (EF) deficits.
  • Electroconvulsive therapy (ECT) is a highly effective treatment for severe depression, but its impact on EF requires further investigation.

Purpose of the Study:

  • To assess executive functions (EF) in patients with TRD before and after bitemporal electroconvulsive therapy (ECT).
  • To explore the relationship between depression severity and performance on executive tasks post-ECT.

Main Methods:

  • 29 patients with TRD undergoing bitemporal ECT were assessed at baseline, immediately after ECT, and 1 month later.
  • Executive functions were evaluated using the Stockings of Cambridge (SOC) test, measuring problem-solving (SOC-P), initial thinking time (SOC-I), and subsequent thinking time (SOC-T).

Main Results:

  • Depression severity significantly decreased post-ECT, with no negative impact on overall EF.
  • Only initial thinking time (SOC-I) improved, correlating with reduced depressive symptoms.
  • Patients with higher psychiatric hospitalization and ECT history were more prone to drop-out and showed longer subsequent thinking times (SOC-T).

Conclusions:

  • ECT does not cause lasting executive function deficits in TRD patients.
  • ECT-induced mood improvement is associated with enhanced planning efficiency (reduced SOC-I).