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Monday August 20 2018

The Long-Term Efficacy and Cognitive Effects of Electroconvulsive Therapy in Individuals with Depression and Anxiety

Electroconvulsive therapy (ECT) is a recognized intervention for treatmentresistant depression (TRD). However, uncertainty remains regarding the severity and duration of ECT-related cognitive impairments and whether psychiatric co-morbidities such as anxiety contribute to residual impairments. This study investigates the efficacy and cognitive outcomes of bilateral, brief-pulse ECT for TRD up to 6 months post-ECT. Additionally, it explores whether patients with co-morbid anxiety respond differently to ECT compared to individuals with only depression. Out of 118 outpatients receiving ECT, 17 (5-Depression; 12-Anxiety & Depression) fit the inclusion criteria. Assessment measures included: Beck Depression Inventory-II (BDI-II), Personality Assessment Inventory (PAI), Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and Squire Subjective Memory Questionnaire (SSMQ). Assessments were performed at baseline, following the 4th ECT, 2-4 weeks post-ECT, and 6 months post-ECT. BDI-II results indicated that bilateral, brief-pulse ECT is an effective acute treatment for TRD. In patients diagnosed with comorbid depression and anxiety, benefits are maintained up to 6 months post-ECT. Additionally, PAI anxiety levels decreased significantly with treatment of depression. The patients’ objective cognitive functioning measured by the RBANS was within the average range, and no significant cognitive changes were detected over time. The SSMQ results indicated that patients’ reported subjective memory impairment did not change significantly over time. Contrary to this, the subrgoup of patients with co-morbid depression and anxiety had significantly lower RBANS scores overall. However, the small sample size and medication differences provide substantial impetus for further investigation.

Written By Christina Puccinelli & Heather McNeely

References may be found in the journal. 

 

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