Article

Cognitive Status of Psychiatric Patients Under Maintenance Electroconvulsive Therapy: A One-Year Longitudinal Study

Universidad de Valladolid, Valladolid, Castille and León, Spain
Journal of Neuropsychiatry (Impact Factor: 2.82). 02/2004; 16(4):465-71. DOI: 10.1176/appi.neuropsych.16.4.465
Source: PubMed

ABSTRACT

In recent years, maintenance electroconvulsive therapy (M-ECT) has been a common treatment within psychiatric practice. Little information is available regarding the cognitive risks of this treatment, however. In this study, twenty psychiatric outpatients were assessed during M-ECT and 1 year later on treatment. A comprehensive cognitive battery was administered, and a separate comparison group was used to calculate the Reliable Change Index. Global cognitive measures showed no significant difference in scores over time. Our results concur with those described in case reports and suggest that there is no significant association between cognitive decline and M-ECT.

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    • "In this study, memory functions improved after 9 weeks and there was no significant difference between an ECT + AP group and antipsychotic only (AP) group. Rami et al. (2004) reported no significant changes in the Trail Making Test (TMT) results after M-ECT versus AP treatment in a mixed group of patients, including six with schizophrenia. De La Serna et al. (2011) also did not detect changes in neuropsychological variables such as working memory, executive functions, and attention, measured by the TMT and Wisconsin Cart Sorting Test (WCST), in adolescent patients with schizophrenia spectrum disorders (schizoaffective n = 2, schizophrenia n = 7) after combined electroconvulsive therapy versus AP. "
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    ABSTRACT: An analysis of literature shows that there is still little evidence concerning the efficacy of electroconvulsive therapy (ECT) combined with antipsychotic therapy in a group of treatment-resistant schizophrenia patients. More precisely, its influence on cognitive functions is still equivocal. The aim of this study was to assess the influence of ECT combined with antipsychotic therapy on working memory, attention, and executive functions in a group of treatment-refractory schizophrenia patients. Twenty-seven patients completed the study: 14 men and 13 women, aged 21 to 55 years (mean age, 32.8 years), diagnosed with treatment-resistant schizophrenia. Each patient underwent a course of ECT sessions and was treated with antipsychotic medications. Before the ECT and within 3 days after the last ECT session, the participants were assessed with the following neuropsychological tests: Trail Making Test (TMT) and Wisconsin Cart Sorting Test (WCST). There were no significant differences in the TMT and WCST results after combined ECT and antipsychotic therapy in treatment-refractory schizophrenia patients. According to the results of the neuropsychological tests, there was no decline in attention, executive functions, or working memory. The current study shows no significant difference in attention, working memory, or executive functions after treatment with a combination of electroconvulsive and antipsychotic therapy. This suggests that combined electroconvulsive therapy may not have a negative influence on the neuropsychological functioning of patients with treatment resistant schizophrenia.
    No preview · Article · Feb 2015 · Journal of Nervous & Mental Disease
    • "In this study, memory functions improved after 9 weeks and there was no significant difference between an ECT + AP group and antipsychotic only (AP) group. Rami et al. (2004) reported no significant changes in the Trail Making Test (TMT) results after M-ECT versus AP treatment in a mixed group of patients, including six with schizophrenia. De La Serna et al. (2011) also did not detect changes in neuropsychological variables such as working memory, executive functions, and attention, measured by the TMT and Wisconsin Cart Sorting Test (WCST), in adolescent patients with schizophrenia spectrum disorders (schizoaffective n = 2, schizophrenia n = 7) after combined electroconvulsive therapy versus AP. "
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    ABSTRACT: The effectiveness and predictors of response to electroconvulsive therapy (ECT) combined with antipsychotics (AP) in treatment-resistant schizophrenia patients with the dominance of negative symptoms (TRS-NS) have not been studied systematically so far. 29 patients aged 21-55 years diagnosed with TRS-NS underwent ECT combined with antipsychotics (ECT+AP). Prior to the ECT, the symptom profile and severity were evaluated using Positive and Negative Syndrome Scale (PANSS). Demographic and medical data was collected; ECT parameters and pharmacotherapy results were evaluated. After the combined ECT+AP therapy a significant decrease in symptom severity was found. A response to treatment was achieved by 60% of patients. The greatest reductions were obtained in general and positive PANSS subscale (median change: 11 and 7 pts.) and the smallest, but still significant, ones in negative symptoms subscale (median: 3.5 pts.). Patients who responded to ECT+AP demonstrated a significantly shorter duration of the current episode in comparison with patients who did not experience at least a 25% reduction in symptom severity (median: 4 vs. 8 months). A combination of ECT and antipsychotic therapy can provide a useful treatment option for patients with TRS-NS. The only significant predictor of response to treatment was a shorter duration of the current episode.
    No preview · Article · Aug 2014
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    • "Maintenance ECT (mECT) has a role in the treatment of refractory MDD, although some memory deficits have been reported [8]. The association between cognitive decline and mECT seems to be non-significant [9]. "
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    ABSTRACT: It is difficult to treat patients who, in addition to having severe anorexia nervosa, also have severe symptoms of major depressive disorder and a tendency for impulsive acting out behaviour. Our case report considers the feasibility of maintenance electroconvulsive therapy in such complicated cases. This is a case report of a woman with anorexia nervosa and co-morbid severe major depressive disorder who was treated with electroconvulsive therapy as a maintenance treatment. The maintenance electroconvulsive therapy was conducted without immediate complications. It had a positive effect on the patient's depressive symptoms and lability and her general wellbeing, although some cognitive deficits were observed. The maintenance electroconvulsive therapy seemed to support recovery in a case of refractory anorexia nervosa and a tendency for labile mood. The symptoms of co-occurring major depressive disorder were partly relieved and maintenance electroconvulsive therapy had some positive effect on weight gain.
    Full-text · Article · Dec 2009 · Cases Journal
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