Cognitive functioning in patients with schizophrenia on long-term maintenance electroconvulsive therapy – A case series

Schizophrenia is a complex disorder with heterogeneous course with the majority of patients having multiple relapses. Electroconvulsive therapy (ECT) when combined with antipsychotics is a potential option in preventing relapse of psychotic symptoms. The cumulative effects of long-term maintenance ECT on cognitive functions in schizophrenia are unknown. We aim to report the cognitive profile of patients with schizophrenia who received long-term maintenance electroconvulsive therapy (M-ECT). The socio-demographic details, illness characteristics, details about ECT were obtained from retrospective file review. The scores on the Hindi Mental Status Examination (HMSE) were compared before and after the latest session of M-ECT. After obtaining written informed consent, cognitive functions were evaluated in detail by using Montreal Cognitive Assessment (MoCA) and Battery for ECT Related Cognitive Deficits (B4ECT-ReCoDe) which is a specific tool to assess cognitive functions that are affected by ECT. 5 patients (2 male and 3 female) with a mean age of 44.2 years (SD 8.5) received M-ECT over a period of 8 years. There was an improvement in the overall functioning of patients. Verbal episodic memory, visual memory and working memory were the affected cognitive domains with preserved processing speed, sustained attention, autobiographical memory, and global cognitive functioning.