scholarly journals Subjective memory impairment after electroconvulsive therapy – potentially modifiable?

BJPsych Open ◽  
2020 ◽  
Vol 6 (3) ◽  
Author(s):  
Kate Eggleston ◽  
Richard Porter

Memory impairment is an important side-effect of electroconvulsive therapy (ECT). However, predicting which patients are at increased risk of developing this is difficult. The study by Sigström et al compares patients’ experience of memory difficulties before and after ECT and suggests that patients with negative expectations of ECT's memory effects are more likely to have subjective memory worsening post-ECT. This intriguing finding suggests that clinicians may be able to modify the risk of patients developing subjective memory difficulties post-ECT by providing appropriate information and addressing concerns prior to treatment, during the informed consent process.

BJPsych Open ◽  
2020 ◽  
Vol 6 (2) ◽  
Author(s):  
Robert Sigström ◽  
Axel Nordenskjöld ◽  
Anders Juréus ◽  
Caitlin Clements ◽  
Erik Joas ◽  
...  

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.


2020 ◽  
Vol 36 (4) ◽  
pp. 272-278
Author(s):  
Elsa Tornhamre ◽  
Carl Johan Ekman ◽  
Åsa Hammar ◽  
Mikael Landen ◽  
Johan Lundberg ◽  
...  

1975 ◽  
Vol 127 (6) ◽  
pp. 609-611 ◽  
Author(s):  
Joan Gomez

SummaryThe incidence of side-effects present 24 hours after electroconvulsive therapy was studied in 96 patients who between them received 500 treatments in a consecutive series. None of the side-effects occurred frequently: headache was experienced after 2·6 per cent and subjective memory impairment after 3 per cent of treatments. None of the unwanted effects held any serious physical threat. The aspect of ECT most disliked by the patients in this study, and mentioned by 16 per cent of them, was the fear of permanent memory upset.


2008 ◽  
Vol 23 (5) ◽  
pp. 321-330 ◽  
Author(s):  
Khaled Abdulrab ◽  
Reinhard Heun

AbstractBackgroundSubjective Memory Impairment (SMI) may hold value in the elderly as a predictor of dementia. There is yet to exist any standard definition of SMI for use in research or for clinical practice.ObjectiveThis study aims to identify previous and current definitions of SMI used in published research and to propose a set of criteria that may help increase SMI's predictive power of future cognitive decline.MethodsLiterature searches were conducted across a number of electronic databases including Medline.Results515 citations were identified, 336 papers were obtained, of which 44 were selected for containing definitions for SMI. These definitions varied widely in terms of the types of questions used to determine SMI and additional features pertaining to memory complaints included in the definition.ConclusionThere is no consistency in how SMI is defined. We propose a set of criteria aimed to increase specificity of memory complainers for those at increased risk of dementia. Further research is required to refine and validate the different criteria suggested. An international consent on the necessary criteria by experts in the field might be useful.


2005 ◽  
Vol 20 (3) ◽  
pp. 199-204 ◽  
Author(s):  
Reinhard Heun ◽  
Sandra Hein

AbstractBackgroundSeveral risk factors of depression have been identified in retrospective as well as some prospective studies in the elderly. Confirmation in independent samples is needed. The present follow-up study prospectively investigated risk factors of depression in an elderly German sample.MethodsOne thousand four hundred and thirty-one subjects from a family study were re-investigated after 4.7 ± 2.5 years. Bivariate and multivariate forward logistic regression analyses were used to identify risk factors of the development of new depression in the elderly.ResultsRisk factors of a new depressive episode in 1408 elderly without current depression were age, female gender, a previous depression, subjective memory impairment, previous anxiety and somatoform disorders. The presence of dementia or mild cognitive impairment were significant risk factors in bivariate, but not multivariate analysis controlling for possible confounding. Risk factors of a first geriatric depressive episode were age, gender and subjective memory impairment; age remained the only significant risk factor in multivariate analysis.ConclusionsThis investigation confirms previous studies from other countries concerning the relevance of risk factors for depression in the elderly. The knowledge of risk factors might help identify subjects at increased risk of depression for early intervention approaches. Elderly with a history of previous depression carry the highest risk.


2020 ◽  
Vol 17 (4) ◽  
pp. 373-381
Author(s):  
Wuhai Tao ◽  
Jinping Sun ◽  
Xin Li ◽  
Wen Shao ◽  
Jing Pei ◽  
...  

Background: Subjective Memory Impairment (SMI) may tremendously increase the risk of Alzheimer’s Disease (AD). The full understanding of the neuromechanism of SMI will shed light on the early intervention of AD. Methods: In the current study, 23 Healthy Controls (HC), 22 SMI subjects and 24 amnestic Mild Cognitive Impairment (aMCI) subjects underwent the comprehensive neuropsychological assessment and the resting-state functional magnetic resonance imaging scan. The difference in the connectivity of the Default Mode Network (DMN) and Functional Connectivity (FC) from the Region of Interest (ROI) to the whole brain were compared, respectively. Results: The results showed that HC and SMI subjects had significantly higher connectivity in the region of the precuneus area compared to aMCI subjects. However, from this region to the whole brain, SMI and aMCI subjects had significant FC decrease in the right anterior cingulum, left superior frontal and left medial superior frontal gyrus compared to HC. In addition, this FC change was significantly correlated with the cognitive function decline in participants. Conclusion: Our study indicated that SMI subjects had relatively intact DMN connectivity but impaired FC between the anterior and posterior brain. The findings suggest that long-distance FC is more vulnerable than the short ones in the people with SMI.


2015 ◽  
Vol 86 (11) ◽  
pp. e4.152-e4
Author(s):  
Baba Aji ◽  
Andrew Larner

ObjectiveTo examine the diagnostic utility of the dementia screening question from the DoH Dementia CQUIN document (2012) in consecutive patients in a dedicated epilepsy clinic, individuals in whom memory complaints are common.Results100 consecutive outpatients (M:F=61:39, median age 44.5 years) were asked ‘Have you been more forgetful in the past 12 months to the extent that it has significantly affected your life?’, as advocated in the Dementia CQUIN document. There was a 48% yes response. No patient was adjudged to have dementia. Comparing the yes/no groups, there was no difference in sex ratio, age, seizure type, or use of antiepileptic drugs (monotherapy versus polytherapy). Those answering yes were more likely to be follow-up than new patients. Intergroup difference in epilepsy duration showed a trend to longer duration in the yes group. The most common examples of memory problems volunteered were forgetting to attend appointments, take medications, or switch off appliances, suggestive of attentional rather than mnestic problems.ConclusionsThese data suggest that the Dementia CQUIN screening question has very low specificity, and hence will identify many false positives, with risk of overdiagnosis of dementia in individuals with purely subjective memory impairment.


2013 ◽  
Vol 9 ◽  
pp. P410-P411
Author(s):  
Dix Meiberth ◽  
Lukas Scheef ◽  
Henning Boecker ◽  
Frank Jessen

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