Tornhamre Elsa, Hammar Åsa, Nordanskog Pia, Nordenskjöld Axel
University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway; Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden; Office for Psychiatry and Habilitation, Psychiatry Research Skåne, Region Skåne, Sweden.
J Affect Disord. 2025 Mar 1;372:324-332. doi: 10.1016/j.jad.2024.12.028. Epub 2024 Dec 5.
Electroconvulsive therapy (ECT) is an effective treatment for depression with potential transient cognitive side effects. However, subjective memory impairment can extend over a long period after ECT.
This study aimed to assess potential risk factors for long-term subjective memory impairment 6 months after ECT and to explore if the associations are mediated by depressive symptoms.
This registry-based study used the Swedish National Quality Register for ECT and other national registers. Long-term subjective memory worsening was defined as a minimum 2-step worsening on the memory item from the comprehensive psychopathological rating scale (CPRS-M) from before ECT to 6 months after ECT. Changes on the scale were also analyzed in continuous models. Statistical methods used were logistic regression and linear regression analyses in univariable and multivariable models.
The study population consisted of 1498 patients. Subjective memory worsening occurred in 25.2 % of the population. Long-term subjective memory worsening was associated with more depressive symptoms and lower education levels. No association could be found related to ECT technical factors. The associations between age and psychiatric comorbidities with subjective memory worsening were mediated by depressive symptoms.
Patients can be informed that depressive symptoms are one of the biggest contributing factors to long-term subjective memory impairment after ECT. A successful treatment is therefore important to minimize the long-term experience of memory deficits. The number of sessions or ECT technical factors do not seem to be associated with long-term subjective memory impairment.
电休克治疗（ECT）是一种治疗抑郁症的有效方法，但可能会产生短暂的认知副作用。然而，ECT后的主观记忆障碍可能会持续很长时间。
本研究旨在评估ECT后6个月长期主观记忆障碍的潜在风险因素，并探讨这些关联是否由抑郁症状介导。
这项基于登记处的研究使用了瑞典国家ECT质量登记处和其他国家登记处的数据。长期主观记忆恶化定义为从ECT前到ECT后6个月，综合精神病理学评定量表（CPRS-M）中记忆项目至少下降2级。还在连续模型中分析了该量表的变化。使用的统计方法是单变量和多变量模型中的逻辑回归和线性回归分析。
研究人群包括1498名患者。25.2%的人群出现了主观记忆恶化。长期主观记忆恶化与更多的抑郁症状和更低的教育水平相关。未发现与ECT技术因素有关的关联。年龄和精神共病与主观记忆恶化之间的关联由抑郁症状介导。
可以告知患者，抑郁症状是ECT后长期主观记忆障碍的最大促成因素之一。因此，成功的治疗对于尽量减少记忆缺陷的长期体验很重要。治疗次数或ECT技术因素似乎与长期主观记忆障碍无关。
