Neuropsychiatric Disease and Treatment (Jan 2023)

Trajectories of Efficacy and Cognitive Function During Electroconvulsive Therapy Course in Young Adults with Treatment-Resistant Depression

  • Xu S,
  • Xie X,
  • Yao L,
  • Chen L,
  • Wan Q,
  • Chen Z,
  • Liu Z

Journal volume & issue
Vol. Volume 19
pp. 267 – 281

Abstract

Read online

Shu-xian Xu,1,* Xin-hui Xie,1,* Lihua Yao,1 Li-chang Chen,2 Qirong Wan,1 Zhen-hua Chen,1 Zhongchun Liu1,3 1Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China; 2Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of China; 3Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhongchun Liu, Department of Psychiatry, Renmin Hospital of Wuhan University, No. 238, Jiefang Road, Wuhan, Hubei, ZIP 430060, People’s Republic of China, Tel +86-8804191181399, Email [email protected]: Little is known about the effectiveness and cognitive side-effects of electroconvulsive therapy (ECT) in young adults with treatment-resistant depression (TRD). The primary aim of this prospective longitudinal observational trial was to examine the clinical features and cognitive outcomes of young adults with TRD undergoing ECT.Methods: Changes in depressive symptoms and objective and subjective cognitive function were assessed using repeated evaluation at baseline, after each ECT session, and at one-month follow-up using the Montgomery-Äsberg Depression Rating Scale (MADRS) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Forward Digital Span Test (FDST), and part of the Columbia Subjective Side Effects Schedule.Results: Of 41 inpatients, 35 (85.4%) and 12 (29.3%) met the criteria for response and remission after ECT, respectively. The greatest clinical improvements occurred during the first 3– 4 ECT sessions. While 34 patients reported subjective cognitive impairment increased with ECT, immediate and delayed memory (RBANS) significantly increased after ECT, consistent with FDST results. Objective cognition significantly improved during follow-up, but subjective cognition remained impaired.Conclusion: ECT is effective in young adults with TRD. Although subjective cognitive impairment increased during treatment, objective cognitive impairments were not observed.Keywords: electroconvulsive therapy, young adults, cognitive function, treatment-resistant depression

Keywords