Electroconvulsive Therapy Impact on Memory Performance in Patients With Depression

Oscar Mauricio Castaño Ramírez , Carlos Andrés Gómez Bedoya , Rocío Lemos Buitrago , Juan Carlos Castro Navarro , Luis Guillermo Valencia Aristizábal , Alexandra Valderrama Sánchez , Pablo Felipe Botero , Mayra Alejandra Reinoso Gualtero
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引用次数: 1

Abstract

Introduction

The safety of electroconvulsive therapy has improved greatly over the last decades, making the potentially adverse effects on memory and other neurocognitive functions the main clinical aspect of concern in the present. In Colombia, the general population and healthcare professionals (even some psychiatrists) seem to have mostly negative opinions towards electroconvulsive therapy treatment, but maybe this could be reconsidered if more information is provided; therefore, the aim of the present study was to evaluate the changes in memory and the severity of the symptoms in a group of patients with severe depression before and after electroconvulsive therapy.

Methods

Twenty-three patients ranging in age from 23 to 70 years from the electroconvulsive therapy service at the San Juan de Dios Clinic (Manizales, Colombia) were recruited in order to assess the effect of electroconvulsive therapy on memory in patients with severe depression. Depressive symptoms and memory were assessed with the Hamilton Depression Scale (HAMD) and Rey Auditory Verbal Learning Test (RAVLT), respectively. The assessment was administered to participants before the initial treatment of electroconvulsive therapy series (0-1 day) and 2 days after their last treatment.

Results

Electroconvulsive therapy resulted in significant improvement in the rating of depression. There were no significant differences in the five learning trials, delayed recall, learning and forgetting scores from pre-treatment to post-treatment. Significant pre-treatment/post-treatment differences were found in the delayed recognition trial.

Conclusions

Pre- and post- electroconvulsive therapy cognitive assessment is a feasible and useful procedure. In general, memory performance does not worsen after electroconvulsive therapy in patients with depression. Only delayed recognition is affected a few days following electroconvulsive therapy, particularly in patients with low educational level and bitemporal (BT) electrode placement.

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电休克治疗对抑郁症患者记忆表现的影响
引言在过去的几十年里,电休克治疗的安全性大大提高,对记忆和其他神经认知功能的潜在不良影响成为目前临床关注的主要方面。在哥伦比亚,普通民众和医疗保健专业人员(甚至一些精神科医生)似乎对电休克治疗大多持负面意见,但如果提供更多信息,也许可以重新考虑这一点;因此,本研究的目的是评估一组重度抑郁症患者在电休克治疗前后记忆和症状严重程度的变化。方法从哥伦比亚马尼萨莱斯市圣胡安德迪奥斯诊所的电休克治疗服务中心招募23名年龄在23岁至70岁之间的患者,以评估电休克治疗对严重抑郁症患者记忆的影响。抑郁症状和记忆力分别用汉密尔顿抑郁量表(HAMD)和雷伊听觉言语学习测试(RAVLT)进行评估。该评估在电休克治疗系列的初始治疗之前(0-1天)和最后一次治疗后2天对参与者进行。结果电休克治疗能显著提高患者的抑郁程度。从治疗前到治疗后,五项学习试验、延迟回忆、学习和遗忘得分没有显著差异。在延迟识别试验中发现了显著的治疗前/治疗后差异。结论电休克治疗前后的认知评估是一种可行、有效的方法。一般来说,抑郁症患者接受电休克治疗后,记忆力不会恶化。只有延迟识别在电休克治疗后几天才会受到影响,尤其是在低教育水平和双颞(BT)电极放置的患者中。
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