Longitudinal reference data for the German D-AMI in major depression and healthy controls: implications for future...

Electroconvulsive therapy (ECT) is an effective treatment for major depressive disorder (MDD). Retrograde autobiographical memory impairment is considered one of the clinically relevant adverse effects of ECT; however, no validated German instrument is available to assess autobiographical memory. Although longitudinal autobiographical memory data are available from previous studies of patients with depression not receiving ECT, corresponding reference data for the German-language AMI-SF have not been established. This study evaluated the feasibility and interrater reliability of the German Autobiographical Memory Interview-Short Form (D-AMI) and established longitudinal reference data in MDD and healthy controls.

Sixty participants (30 patients with MDD and 30 healthy controls), none of whom received ECT during the observation period, completed the D-AMI at baseline and after a 6-week interval. Feasibility was assessed by completion rates and missing data. Interrater reliability was evaluated in a subset (n = 10) using a two-way random-effects intraclass correlation coefficient (ICC). Longitudinal performance was quantified using D-AMI score change and its baseline-normalized expression, retrieval consistency. Associations between autobiographical memory measures and depressive symptom severity were explored.

The D-AMI demonstrated a 100% completion rate with no missing data. Interrater reliability was ICC[2,1] = 0.71 (95% CI = 0.17-0.92), indicating considerable uncertainty. The magnitude of longitudinal inconsistency was greater in patients with MDD than in healthy controls, although this between-group difference should be interpreted cautiously because study site and rater were confounded with group.

The D-AMI is a feasible instrument for assessing autobiographical memory in German-speaking populations, while the preliminary interrater reliability estimate requires confirmation in larger samples. The observed magnitude of longitudinal D-AMI inconsistency provides reference information for repeated assessments in the absence of ECT; however, the between-group difference requires cautious interpretation because group, site, and rater effects could not be separated. These findings provide the first longitudinal reference data for the German D-AMI and indicate that changes in autobiographical memory scores should not automatically be interpreted as evidence of ECT-related memory impairment. Rather, such changes should be considered in the context of test-retest variability and retrieval consistency.