title: Episodic Visual Learning/Memory and Attentional Flexibility in Patients With Major Depressive Disorder After Clinically Effective Electroconvulsive Therapy.
abstract: OBJECTIVE
  This study is a follow-up of a previous one reporting that the neuropsychological profile of pharmacoresistant patients with major depressive disorder referred for electroconvulsive therapy (ECT, ECT group) contrasted with that of their pharmacorespondent counterparts (NECT group). The NECT group exhibited severe visuospatial memory and minor executive deficits; the ECT group presented the reverse pattern. In that same ECT group, the current follow-up study examined the effects of clinically effective ECT on both cognitive domains 2 months later.
  
  
  METHODS
  Fifteen ECT patients were administered Hamilton Depression (HAMD-24), Hamilton Anxiety (HAMA), Mini-Mental State Examination Scales and 5 tests of Cambridge Neuropsychological Test Automated Battery at intake (pre-ECT), end of ECT course (post-ECT), and 2 months thereafter (follow-up).
  
  
  RESULTS
  Electroconvulsive therapy was effective in relieving clinical depression. After a post-ECT decline, the patients exhibited significant improvement in both Cambridge Neuropsychological Test Automated Battery, paired associate learning, and Stockings of Cambridge. By contrast, their major pre-ECT deficit in intra/extradimensional set shifting remained virtually unaffected.
  
  
  CONCLUSIONS
  Our findings suggest that attentional flexibility deficits may constitute a neuropsychological trait-like feature of pharmacoresistant, ECT-referred major depressive disorder patients. However, this deficit does not seem generalized, given patient improvement in episodic visual learning/memory and some indication of improvement in spatial planning after ECT.
authors.affiliation: From the *Experimental Psychology Laboratory, 1st Department of Psychiatry, Eginition Hospital, Athens University Medical School, Athens, Greece; †Laboratory of Experimental and Applied Behavior Analysis, Department of Psychology, Panteion University of Social and Political Sciences; ‡1st Department of Psychiatry, Eginition Hospital, Athens University Medical School; Athens, Greece §Section of Cognitive Neuropsychiatry, Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK; ∥Unit for the Study of Cognition in Psychosis, Psychiatric Hospital of Attica, Athens, Greece.
authors.forename: Stamatina
authors.initials: S
authors.lastname: Kalogerakou
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Oulis
authors.forename: Eleni
authors.initials: E
authors.lastname: Anyfandi
authors.forename: George
authors.initials: G
authors.lastname: Konstantakopoulos
authors.forename: Vasiliki-Maria
authors.initials: VM
authors.lastname: Papakosta
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kontis
authors.forename: Eirini
authors.initials: E
authors.lastname: Theochari
authors.forename: Elias
authors.initials: E
authors.lastname: Angelopoulos
authors.forename: Ioannis M
authors.initials: IM
authors.lastname: Zervas
authors.forename: Robert C
authors.initials: RC
authors.lastname: Mellon
authors.forename: Charalambos C
authors.initials: CC
authors.lastname: Papageorgiou
authors.forename: Eleftheria
authors.initials: E
authors.lastname: Tsaltas
mesh_terms: D001245:Association Learning; D001288:Attention; D003865:Major Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D061218:Depressive Disorder, Treatment-Resistant / Q000523:psychology / Q000628:therapy; D004565:Electroconvulsive Therapy / Q000009:adverse effects* / Q000523:psychology*; D056344:Executive Function; D005500:Follow-Up Studies; D006801:Humans; D007858:Learning; D008297:Male; D061212:Memory, Episodic; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D065852:Spatial Memory; D016896:Treatment Outcome