Cognitive functions and electroconvulsive therapy in affective psychiatric patients

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Published: 2018-06-15
DOI: https://doi.org/10.18566/medupb.v37n1.a04

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Constaín, G. A., Ocampo Saldarriaga, M. V., Rodríguez Gásquez, M. de los Ángeles, Restrepo Zapata, J. C., & Monroy Duque, D. (2018). Cognitive functions and electroconvulsive therapy in affective psychiatric patients. Medicina UPB, 37(1), 25-35. https://doi.org/10.18566/medupb.v37n1.a04
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Gustavo A. Constaín
Psychiatrist, Coordinator of the Enlace Psychiatry Group, Faculty of Medicine, Universidad Pontificia Bolivariana, Medellín, Colombia.
María Victoria Ocampo Saldarriaga
Psychiatrist, Professor, Faculty of Medicine, Universidad Pontificia Bolivariana, Medellín, Colombia.
María de los Ángeles Rodríguez Gásquez
RN, Ph.D. in Public Health, Faculty of Nursing, Universidad Pontificia Bolivariana, Medellín, Colombia.
Julio César Restrepo Zapata
Psychiatrist, Professor of the Faculty of Medicine, Universidad Pontificia Bolivariana, Medellín, Colombia.
David Monroy Duque
Psychiatrist Universidad Pontificia Bolivariana, Medellín, Colombia.

Abstract

Objective: Electroconvulsive therapy (ECT) has been considered a safe and effective treatment for depression, manic episodes, and other serious psychiatric conditions. Its main reported side effect has been cognitive impairment. This study describes the cognitive effects of ECT in psychiatric patients referred for treatment at a private clinic.


Methodology: Descriptive case series study. A baseline assessment conducted before starting ECT, and another two (at one week and at six months) after completing the treatment cycle were used to describe the effects of frontotemporal bilateral ECT on neurocognitive function in terms of the change from the baseline to the final assessment in the domains of memory, psychomotor speed, reaction time, complex attention, and cognitive flexibility, as well as global cognitive function, as well as to determine ECT’s safety by reporting adverse events. Cognitive assessment was conducted with a neuropsychological test battery and severity of psychiatric illness with the Clinical Global Impression-Severity scale (CGI-S). Six patients referred for treatment during six months were included.


Results: No statistically significant differences were observed between the medians of the evaluations of CGI-S scale, global cognitive function or any of the domains evaluated.


Conclusions: ECT did not produce changes in the cognitive functions assessed in the six studied patients.

Keywords:
electroconvulsive therapy, cognitive functions, adverse events, neuropsychological evaluation

Article Details

References

Faedda GI, Becker I, Baroni A, Tondo L, Aspland E, Koukopoulos A. The origins of electroconvulsive therapy: Prof. Bini’s first report on ECT. J Affect Disord 2010; 120:12–15.

American Psychiatric Association. The practice of electroconvulsive therapy: Recommendations for treatment, training and privileging: A task force report. 2nd ed. Washington, DC: American Psychiatric Association; 2001.

Scott AIF, editor. The ECT handbook. 2nd ed. London: Royal College of Psychiatrists; 2005.

Ottosson JO, Fink M. Ethics in electroconvulsive therapy. New York: Routledge; 2004.

Abrams R. Electroconvulsive therapy. 4th ed. New York: Oxford University Press; 2002.

Burrows GD, Norman TR. Treatment-resistant unipolar depression. In: Lader M, Naber D, editors. Difficult clinical problems in psychiatry. London: Martin Dunitz; 2001:57-75.

Sachs GS. Treatment of acute depression in bipolar disorder. In: Ketter TA, editor. Advances in treatment of bipolar disorder. Arlington: American Psychiatric Publishing; 2005:57-109.

Devanand DP, Lisanby SH, Sackeim HA. Special somatic treatments. In: Dewan MJ, Pies RW, editors. The Difficult to treat psychiatric patient. Washington, DC: American Psychiatric Publishing; 2001:359-392.

Meeter M, Murre JMJ, Janssen SMJ, Birkenhager T, van den Broek WW. Retrograde amnesia after electroconvulsive therapy: A temporary effect? J Affect Disord 2011;132(1-2):216-222.

Gardner BK, O´Connor DW. A review of the cognitive effects of electroconvulsive therapy in older adults. J ECT 2008;24(1):68-80.

Mukherjee S, Sackeim HA, Schunur DR. Electroconvulsive therapy in acute manic episodes: A review of 50 years’ experience. Am J Psychiatry 1994;151:169-176.

Versiani M, Cheniaux E, Landeira-Fernandez J. Efficacy and safety of electroconvulsive therapy in the treatment of bipolar disorder. A systematic review. J ECT 2011;27(2):153-164.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Text Revision DSM-IV-TR. 4th ed. Washington, DC: American Psychiatric Association; 2000.

Guy W. ECDEU Assessment manual for psychopharmacology-revised. Rockville MD: D.H.E.W. Publ. No ADM 91-338; 1976:218-222.

Gualtieri CT, Johnson LG. Reliability and validity of a computerized neurocognitive test battery, CNS Vital Signs. Arch Clin Neuropsychol 2006; 21(7):623-643.

CNS Vital Signs [Web site].Chapel Hill, N C: Users manual. c2003-10. Available at: www.CNSVS. com. Accessed April 18, 2011.

Gualtieri CT, Morgan DW. The frequency of cognitive impairment in patients with anxiety, depression and bipolar disorder: an unaccounted source of variance in clinical trials. J Clin Psychiatry 2008;69(7):1122-1130.

Wysokiński A, Dzienniak M, Kłoszewska I. Assessment of cognitive performance using CNS Vital Signs after electroconvulsive treatment of schizophrenia. J ECT 2014;30(1):e5-6.

Malloy FW, Small IF, Miller MJ Milstein V, Stout JR. Changes in neuropsychological test performance after electroconvulsive therapy. Biol Psychiatry 1982;17(1):61-67.

Ng C, Schweitzer I, Alexopoulos P, Celi E, Wong L, Tuckwell V, et al. Efficacy and cognitive effects of right unilateral electroconvulsive therapy. J ECT 2000;16(4):370-379.

Devanand DP, Verma AK, Tirumalasetti F, Sackeim HA. Absence of cognitive impairment after more than 100 lifetime ECT treatments. Am J Psychiatry 1991; 148(7):929-932.

Sienaert P, Vansteelandt K, Demyttenaere K, Peuskens J. Randomized comparison of ultra-brief bifrontal and unilateral electroconvulsive therapy for major depression: Cognitive side-effects. J Affect Disord 2010;122:60-67.

Shenal BV, Harrison DW, Demaree HA. The neuropsychology of depression: A literature review and preliminary model. Neuropsychol Rev 2003;13:33-42.

Osuji IJ, Cullum CM. Cognition in bipolar disorder. Psychiatr Clin N Am 2005; 28:427-441.

Gualtieri CT, Johnson LG, Benedict KB. Neurocognition in depression: Patients on and off medication versus healthy comparison subjects. J Neuropsychiatry Clin Neurosci 2006;18:217- 225.

Paykel ES. Remission and residual symptomatology in major depression. Psychopathology 1998;31:5-314.

Scott J, Stanton B, Garland A, Ferrier IN. Cognitive vulnerability in patients with bipolar disorder. Psychol Med 2000;30:467-472.

Wilder-Willis KE, Sax KW, Rosemberg HL, Fleck DE, Shear PK, Strakowsky SM. Persistent attentional dysfunction in remitted bipolar disorder. Bipolar Disord 2001;3:58-62.

Sackeim HA, Prudic J, Fuller R, Keilp J, Lavori PW, Olfson M. The cognitive effects of electroconvulsive therapy in community settings. Neuropsychopharmacol 2007;32:244-254.

Ingram A, Schweitzer I, Ng CH, Saling MM, Savage G. A comparison of propofol and thiopentone use in electroconvulsive therapy: Cognitive and efficacy effects. J ECT 2007;23(3):158-162.

Geretsegger C, Nickel M, Judendorfer B, Rochowanski E, Novak E, Aichhorn W. Propofol and methohexital as anesthetic agents for electroconvulsive therapy: A randomized double-blind comparison of electroconvulsive therapy seizure quality, therapeutic efficacy and cognitive performance. J ECT 2007;23(4):239-243.

Sackeim HA, Dillingham EM, Prudic J, Cooper T, McCall WV, Rosenquist P, et al. Effect of concomitant pharmacotherapy on electroconvulsive therapy outcomes. Arch Gen Psychiatry 2009;66(7):729-737.

Honig A, Arts BM, Ponds RWHM, Riedel WJ. Lithium induced cognitive side-effects in bipolar disorder: A qualitative analysis and implications for daily practice. Int Clin Psychopharmacol 1999;14:167-171.

Gualtieri CT, Johnson LG. Comparative neurocognitive effects of 5 psychotropic anticonvulsants and lithium. Med Gen Med. 2006;8(3):46. Available at: http:// www.medscape.com/ viewarticle/541762. Accessed December 03, 2010.

Eschweiler GW, Vonthein R, Bode R, Huell M, Conca A, Peters O, et al. Clinical efficacy and cognitive side effects of bifrontal versus right unilateral electroconvulsive therapy (ECT): A short-term randomised controlled trial in pharmaco-resistant major depression. J Affect Disord 2007;101:149-157.

Harrison BE, Therrien B. Effect of antipsychotic medication use on memory in patients with Alzheimer’s disease: assessing the potential risk for accelerated recent autobiographical memory loss. J Gerontol Nurs 2007;33:11-20.

Tsao J, Shah R, Leurgans S. Impaired cognition in normal individuals using medications with anticholinergic activity occurs following several years. (Abstract S51.001). Academy of Neurology, 60th Annual Meeting, April 17, 2008.

Mankad MV, Weiner RD. Adverse effects. In: Mankad MV, Beyer JL, Weiner RD, Krystal AD, editors. Clinical manual of electroconvulsive therapy. Arlington: American Psychiatric Publishing; 2010:139-148.

Prudic J, Peyser S, Sackeim HA. Subjective memory complaints: A review of patients selfassessment of memory after electroconvulsive therapy. J ECT 2000; 16:121-132.

Squire LR, Chace PM. Memory functions six to nine months after electroconvulsive therapy. Arch Gen Psychiatry 1975;32:1557-1564.