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Subjective Memory Immediately Following Electroconvulsive Therapy.

Ole Brus1, Pia Nordanskog, Ullvi Båve

  • 1From the *Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro; †Center for Social and Affective Neuroscience, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping; ‡Department of Psychiatry, Region Östergötland, Linköping; §Department of Clinical Neuroscience, and ∥Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; ¶Department of Biological and Medical Psychology, University of Bergen, Bergen; #Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; **Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; ††Institute of Neuroscience and Physiology, The Sahlgrenska Academy at Gothenburg University, Gothenburg; ‡‡Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm; and §§School of Medical Sciences, Örebro University, Örebro, Sweden.

The Journal of ECT
|December 9, 2016
PubMed
Summary

Subjective memory worsening (SMW) affects 26% of patients treated with electroconvulsive therapy (ECT). Young women and those receiving brief pulse width stimuli are at higher risk for SMW.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Clinical Psychology

Background:

  • Electroconvulsive therapy (ECT) is a vital treatment for severe depression.
  • Cognitive side effects, including subjective memory worsening (SMW), are a concern for patients undergoing ECT.
  • Understanding factors influencing SMW is crucial for optimizing patient care.

Purpose of the Study:

  • To determine the short-term incidence of subjective memory worsening (SMW) in a large cohort of depression patients treated with ECT.
  • To identify patient characteristics and treatment parameters associated with SMW.

Main Methods:

  • A register-based study of 1212 patients from the Swedish National Quality Register for ECT.
  • SMW defined as a 2-point increase on the memory item of the Comprehensive Psychopathological Rating Scale within one week post-ECT.
  • Logistic regression analysis to examine associations between patient/treatment factors and SMW.

Main Results:

  • SMW was reported by 26% of patients.
  • SMW was more prevalent in women (31%) than men (18%) and in younger adults (18-39 years) compared to older adults (≥65 years).
  • Higher risk of SMW was associated with less pre-ECT memory disturbance, brief pulse width stimuli, and lower risk in patients achieving remission.

Conclusions:

  • SMW affects a minority of patients, but young women are a vulnerable group.
  • Ultrabrief pulse width stimuli may reduce SMW risk, particularly with unilateral electrode placement.
  • Individualized treatment adjustment is essential to balance clinical efficacy and minimize cognitive adverse effects.