title: Neuropsychological effects and attitudes in patients following electroconvulsive therapy.
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 significant decrease in subjective ratings of depression as rated by the BDI, t(45) = 9.82, P < 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 confirmed this decline. More specifically, repeated measures MANOVA [Wilks Lambda F(11,30) = 4.3, p < 0.001] indicated significant decreases for measures of immediate recognition memory (p < 0.005), long-term storage (p < 0.05), delayed prose passage recall (p < 0.0001), percent retained of prose passages (p < 0.0001), and percent retained of visual designs (p < 0.0001). In addition, the number of double mentions on the Levin increased (p < 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 difficulties 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.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center Durham, NC, USA.
authors.forename: Miriam
authors.initials: M
authors.lastname: Feliu
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Edwards
authors.forename: Shiv
authors.initials: S
authors.lastname: Sudhakar
authors.forename: Camela
authors.initials: C
authors.lastname: McDougald
authors.forename: Renee
authors.initials: R
authors.lastname: Raynor
authors.forename: Stephanie
authors.initials: S
authors.lastname: Johnson
authors.forename: Goldie
authors.initials: G
authors.lastname: Byrd
authors.forename: Keith
authors.initials: K
authors.lastname: Whitfield
authors.forename: Charles
authors.initials: C
authors.lastname: Jonassaint
authors.forename: Heather
authors.initials: H
authors.lastname: Romero
authors.forename: Lekisha
authors.initials: L
authors.lastname: Edwards
authors.forename: Chante'
authors.initials: C
authors.lastname: Wellington
authors.forename: LaBarron K
authors.initials: LK
authors.lastname: Hill
authors.forename: James
authors.initials: J
authors.lastname: Sollers
authors.forename: Patrick E
authors.initials: PE
authors.lastname: Logue