title: Executive function in treatment-resistant depression before and after electroconvulsive therapy.
abstract: The aim of this study was to examine executive functions (EF) in patients with treatment-resistant depression (TRD) before and after bitemporal electroconvulsive therapy (ECT) and to evaluate possible associations between the depression severity and executive tasks performances.
  
  
  
  Patients (n = 29), treated with bitemporal ECT, underwent assessment at three time points: baseline, immediately after ECT course and 1 month later. The Stockings of Cambridge (SOC, CANTAB) was used to assess EF: (1) number of problems solved in minimum moves (SOC-P), (2) initial thinking time (SOC-I) and (3) subsequent thinking time (SOC-T).
  
  
  
  The scores on the Hamilton Depression Rating Scale and the Clinical Global Impression scale were significantly reduced over time, with no negative effects on the EF. Among SOC subtests, only SOC-I improved over time, which was significantly correlated with the depressive symptoms reduction. SOC-T and SOC-P remained unchanged and did not correlate with mood. Interestingly, the patients with more lifetime psychiatric hospitalisations and more ECT applications were more likely to drop-out and to have longer SOC-T while performing the test.
  
  
  
  Our results support the view that ECT does not produce long-lasting EF deficits, nor exacerbates the pre-existing ones. The improvement of the EF performances during and after the ECT-induced alleviation of mood symptoms in TRD is based mostly on the reduction of time needed to plan the problem solution.
authors.affiliation: a Clinic for Psychiatry , Military Medical Academy , Belgrade , Serbia.
authors.forename: Zvezdana
authors.initials: Z
authors.lastname: Stojanovic
authors.affiliation: b Clinic for Psychiatry Clinical Center of Serbia , Belgrade , Serbia.
authors.forename: Sanja
authors.initials: S
authors.lastname: Andric
authors.affiliation: c School of Medicine, University of Belgrade , Belgrade , Serbia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Soldatovic
authors.affiliation: a Clinic for Psychiatry , Military Medical Academy , Belgrade , Serbia.
authors.forename: Mirko
authors.initials: M
authors.lastname: Dolic
authors.affiliation: a Clinic for Psychiatry , Military Medical Academy , Belgrade , Serbia.|d Faculty of Medicine of the Military Medical Academy , University of Defense , Belgrade , Serbia.
authors.forename: Zeljko
authors.initials: Z
authors.lastname: Spiric
authors.affiliation: b Clinic for Psychiatry Clinical Center of Serbia , Belgrade , Serbia.|c School of Medicine, University of Belgrade , Belgrade , Serbia.
authors.forename: Nadja P
authors.initials: NP
authors.lastname: Maric
mesh_terms: D000328:Adult; D003865:Major Depressive Disorder / Q000503:physiopathology* / Q000628:therapy*; D061218:Depressive Disorder, Treatment-Resistant / Q000503:physiopathology* / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000009:adverse effects / Q000379:methods*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D017063:Outcome Assessment, Health Care; D012720:Severity of Illness Index
keywords: CANTAB; ECT; Executive functions; The Stockings of Cambridge task; major depression