From the Neurocognition and Emotion in Affective Disorders Group, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet.
Psychiatric Centre Amager.
J ECT. 2022 Mar 1;38(1):30-38. doi: 10.1097/YCT.0000000000000797.
The character and duration of cognitive adverse effects of electroconvulsive therapy (ECT) are unclear. This study investigated (1) the sensitivity of a short cognitive test battery to cognitive adverse effects of ECT, (2) the relation between subjective and objective cognitive adverse effects, and (3) patient characteristics associated with more subjective than objective adverse effects.
Forty-one patients with unipolar or bipolar depression referred to ECT underwent assessments at baseline, 5 to 7 days post-ECT, and 3 months post-ECT. Patients rated their fear of various aspects of ECT on a visual analog scale. At each assessment, patients were evaluated for depressive symptoms, completed the Screen for Cognitive Impairment in Psychiatry (SCIP) and Trail Making Test-Part B (TMT-B), and rated their cognitive difficulties.
Patients feared cognitive adverse effects and lack of treatment efficacy more than other aspects of ECT. The SCIP and TMT-B revealed transient decline in objective cognition after ECT, which was reversed after 3 months. Patients presented with more subjective than objective cognitive difficulties at baseline and more subjective than objective cognitive adverse effects of ECT. This discrepancy was significantly reduced at follow-up. Younger age and poorer objective cognition pretreatment were associated with more subjective than objective cognitive adverse effects 5 to 7 days after ECT.
The SCIP and TMT-B are sensitive to cognitive adverse effects of ECT. Patients show more subjective than objective cognitive adverse effects of ECT. These insights can be used clinically to inform patients of treatment choice and expected cognitive consequences.
电抽搐治疗（ECT）引起的认知不良反应的特征和持续时间尚不清楚。本研究旨在：(1) 评估一种简短认知测试组合对 ECT 认知不良反应的敏感性；(2) 研究主观和客观认知不良反应之间的关系；(3) 与主观不良反应比客观不良反应更明显相关的患者特征。
41 名患有单相或双相抑郁症的患者接受 ECT 治疗，在基线、ECT 后 5-7 天和 3 个月时进行评估。患者使用视觉模拟量表对 ECT 的各个方面的恐惧程度进行评分。在每次评估时，患者接受抑郁症状评估、完成精神科认知障碍筛选量表（SCIP）和连线测试 B 部分（TMT-B），并对认知困难程度进行评分。
患者对认知不良反应和治疗效果缺乏的恐惧程度超过 ECT 的其他方面。SCIP 和 TMT-B 显示 ECT 后客观认知短暂下降，3 个月后恢复正常。患者在基线时的主观认知困难比客观认知困难更明显，ECT 的主观认知不良反应比客观认知不良反应更明显。这种差异在随访时明显减少。年龄较小和预处理时客观认知较差与 ECT 后 5-7 天的主观认知不良反应比客观认知不良反应更明显相关。
SCIP 和 TMT-B 对 ECT 的认知不良反应敏感。患者表现出比 ECT 的客观认知不良反应更明显的主观认知不良反应。这些见解可用于临床，使患者了解治疗选择和预期的认知后果。
