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Cognitive function after electroconvulsive therapy for depression: relationship to clinical response

BACKGROUND: As uncertainty remains about whether clinical response influences cognitive function after electroconvulsive therapy (ECT) for depression, we examined the effect of remission status on cognitive function in depressed patients 4 months after a course of ECT. METHOD: A secondary analysis w...

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Autores principales: Anderson, Ian M., McAllister-Williams, R. Hamish, Downey, Darragh, Elliott, Rebecca, Loo, Colleen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8327625/
https://www.ncbi.nlm.nih.gov/pubmed/32102725
http://dx.doi.org/10.1017/S0033291720000379
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author Anderson, Ian M.
McAllister-Williams, R. Hamish
Downey, Darragh
Elliott, Rebecca
Loo, Colleen
author_facet Anderson, Ian M.
McAllister-Williams, R. Hamish
Downey, Darragh
Elliott, Rebecca
Loo, Colleen
author_sort Anderson, Ian M.
collection PubMed
description BACKGROUND: As uncertainty remains about whether clinical response influences cognitive function after electroconvulsive therapy (ECT) for depression, we examined the effect of remission status on cognitive function in depressed patients 4 months after a course of ECT. METHOD: A secondary analysis was undertaken on participants completing a randomised controlled trial of ketamine augmentation of ECT for depression who were categorised by remission status (MADRS ⩽10 v. >10) 4 months after ECT. Cognition was assessed with self-rated memory and neuropsychological tests of anterograde verbal and visual memory, autobiographical memory, verbal fluency and working memory. Patients were assessed through the study, healthy controls on a single occasion, and compared using analysis of variance. RESULTS: At 4-month follow-up, remitted patients (N = 18) had a mean MADRS depression score of 3.8 (95% CI 2.2–5.4) compared with 27.2 (23.0–31.5) in non-remitted patients (N = 19), with no significant baseline differences between the two groups. Patients were impaired on all cognitive measures at baseline. There was no deterioration, with some measures improving, 4-months after ECT, at which time remitted patients had significantly improved self-rated memory, anterograde verbal memory and category verbal fluency compared with those remaining depressed. Self-rated memory correlated with category fluency and autobiographical memory at follow-up. CONCLUSIONS: We found no evidence of persistent impairment of cognition after ECT. Achieving remission improved subjective memory and verbal memory recall, but other aspects of cognitive function were not influenced by remission status. Self-rated memory may be useful to monitor the effects of ECT on longer-term memory.
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spelling pubmed-83276252021-08-11 Cognitive function after electroconvulsive therapy for depression: relationship to clinical response Anderson, Ian M. McAllister-Williams, R. Hamish Downey, Darragh Elliott, Rebecca Loo, Colleen Psychol Med Original Article BACKGROUND: As uncertainty remains about whether clinical response influences cognitive function after electroconvulsive therapy (ECT) for depression, we examined the effect of remission status on cognitive function in depressed patients 4 months after a course of ECT. METHOD: A secondary analysis was undertaken on participants completing a randomised controlled trial of ketamine augmentation of ECT for depression who were categorised by remission status (MADRS ⩽10 v. >10) 4 months after ECT. Cognition was assessed with self-rated memory and neuropsychological tests of anterograde verbal and visual memory, autobiographical memory, verbal fluency and working memory. Patients were assessed through the study, healthy controls on a single occasion, and compared using analysis of variance. RESULTS: At 4-month follow-up, remitted patients (N = 18) had a mean MADRS depression score of 3.8 (95% CI 2.2–5.4) compared with 27.2 (23.0–31.5) in non-remitted patients (N = 19), with no significant baseline differences between the two groups. Patients were impaired on all cognitive measures at baseline. There was no deterioration, with some measures improving, 4-months after ECT, at which time remitted patients had significantly improved self-rated memory, anterograde verbal memory and category verbal fluency compared with those remaining depressed. Self-rated memory correlated with category fluency and autobiographical memory at follow-up. CONCLUSIONS: We found no evidence of persistent impairment of cognition after ECT. Achieving remission improved subjective memory and verbal memory recall, but other aspects of cognitive function were not influenced by remission status. Self-rated memory may be useful to monitor the effects of ECT on longer-term memory. Cambridge University Press 2021-07 2020-02-27 /pmc/articles/PMC8327625/ /pubmed/32102725 http://dx.doi.org/10.1017/S0033291720000379 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Anderson, Ian M.
McAllister-Williams, R. Hamish
Downey, Darragh
Elliott, Rebecca
Loo, Colleen
Cognitive function after electroconvulsive therapy for depression: relationship to clinical response
title Cognitive function after electroconvulsive therapy for depression: relationship to clinical response
title_full Cognitive function after electroconvulsive therapy for depression: relationship to clinical response
title_fullStr Cognitive function after electroconvulsive therapy for depression: relationship to clinical response
title_full_unstemmed Cognitive function after electroconvulsive therapy for depression: relationship to clinical response
title_short Cognitive function after electroconvulsive therapy for depression: relationship to clinical response
title_sort cognitive function after electroconvulsive therapy for depression: relationship to clinical response
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8327625/
https://www.ncbi.nlm.nih.gov/pubmed/32102725
http://dx.doi.org/10.1017/S0033291720000379
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