Long-term subjective memory after electroconvulsive therapy. Issue 2 (March 2020)

• Record Type: Journal Article
• Authors: Sigström, Robert; Nordenskjöld, Axel; Juréus, Anders; Clements, Caitlin; Joas, Erik; Pålsson, Erik; Landén, Mikael
• Is Part Of: BJPsych open. Volume 6:Issue 2(2020)
• Publication Date: 2020-03
• Subjects: Electroconvulsive therapy, -- memory, -- adverse effects, -- amnesia, -- cognition; Psychiatry -- Periodicals; Mental health -- Periodicals; 616.89005
• DOI: 10.1192/bjo.2020.9
• Languages: English
• ISSNs: 2056-4724

Abstract

Abstract : Background: There have been reports of long-term subjective memory worsening after electroconvulsive therapy (ECT). Aims: To study the prevalence and risk factors of long-term subjective memory worsening among patients receiving ECT in routine clinical practice. Method: Patients ( n = 535, of whom 277 were included in the final analysis) were recruited from eight Swedish hospitals. Participants' subjective memory impairment was assessed before ECT and a median of 73 days after ECT using the memory item from the Comprehensive Psychopathological Rating Scale. Participants also rated their pre-ECT expectations and post-ECT evaluations of the effect of ECT on memory on a 7-point scale. We used ordinal regression to identify variables associated with subjective memory worsening and negative evaluations of the effect of ECT on memory. Results: Comparisons of pre- and post-ECT assessments showed that subjective memory worsened in 16.2% of participants, remained unchanged in 52.3% and improved in 31.4%. By contrast, when asked to evaluate the effect of ECT on memory after treatment 54.6% reported a negative effect. Subjective memory worsening was associated with negative expectations before ECT, younger age and shorter duration of follow-up. Conclusions: Although subjective memory improved more often than it worsened when assessed before and after ECT, a majority of patients reported that ECT had negative effects on their memory when retrospectively asked how ECT had affected it. This might suggest that some patients attribute pre-existing subjective memory impairment to ECT. Clinicians should be aware that negative expectations are associated with subjective worsening of memory after ECT.