The Effect of Electroconvulsive Therapy on Neurocognitive Function in Treatment-Resistant Bipolar Disorder Depression
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OBJECTIVE: To compare the effects of right unilateral (RUL) electroconvulsive therapy (ECT) and algorithm-based pharmacologic treatment (APT) on neurocognitive function in treatment-resistant bipolar disorder depression. METHOD: Inpatients with DSM-IV-TR-diagnosed, treatment-resistant bipolar depression, who were acutely admitted to 1 of the 7 clinical study centers in Norway, were recruited from May 2008 to April 2011 into a prospective, randomized controlled, 6-week acute treatment trial. General neurocognitive function was assessed with the MATRICS Consensus Cognitive Battery (MCCB), and retrograde memory for autobiographical events was assessed with the Autobiographical Memory Interview-Short Form (AMI-SF) before and shortly after (mean = 23.5 days) a trial with either RUL brief-pulse ECT (mean dose = 233.3 mC) or APT. RESULTS: Seventy-three patients entered, and 39 (nECT = 19, nAPT = 20) completed. Both groups showed improvements in all MCCB domain scores, with no significant differences between the study groups (no interaction effect: F₁,₃₇ = 1.52, P = NS). Improvements in neurocognitive performance were significantly correlated with reductions in depression ratings posttreatment. The AMI-SF score was significantly lower (based on consistent answers from pre- to posttreatment) in the ECT group (72.9%) than in the APT group (80.8%, P = .025), indicating reduced consistency in autobiographical memory after ECT. CONCLUSIONS: General neurocognitive function was unaffected by RUL brief-pulse ECT treatment and positively related to improved mood in bipolar depression. Autobiographical memory consistency was reduced in patients treated with ECT. The results suggest that ECT can be used in treatment-resistant bipolar depression without compromising general neurocognitive function. The clinical relevance of reduced autobiographical memory consistency in the ECT group requires further investigation. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00664976.
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The pharmacotherapy group's 19.2% consistency loss was similar to this study's MST AMI-SF decrease of 18.9%, and both were smaller than the 27.1% decrease in Kessler's ECT group.
“The consistency loss in the pharmacotherapy group was similar to the decreased AMI-SF total score in our study with MST (18.9%), which was also less of a decrease than observed in the ECT group of the study by Kessler and colleagues (27.1%).54”
From Magnetic seizure therapy is efficacious and well tolerated for treatment-resistant bipolar depression: An open-label clinical trial (2020) · cites this paper as [54]
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Electroconvulsive Therapy Impact on Memory Performance in Patients With Depression
Ramírez, O. M. C., Bedoya, C. A. G., Buitrago, R. L., Navarro, J. C. C., Aristizábal, L. G. V., Sánchez, A. V., Botero, P. F., & Gualtero, M. A. R. (2021) · Revista Colombiana de Psiquiatría · doi:10.1016/j.rcp.2021.03.001 · Cited by 5 · see citing works
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(2019) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379422.bm01
Chapter 9. Cognitive Effects of ECT
(2019) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379422.lg09
Chapter 4. The Pre-ECT Medical Workup
(2019) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379422.lg04
Chapter 2. Patient Selection for ECT
(2019) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379422.lg02
Chapter 3. Patient Education and Informed Consent for ECT
(2019) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379422.lg03
Chapter 1. Introduction to ECT
(2019) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379422.lg01
Chapter 10. ECT Versus Other Neuropsychiatric Treatments
(2019) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379422.lg10
Chapter 6. ECT Technique, Part I: Managing the Individual Treatment
(2019) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379422.lg06
(2019) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379422.index
(2019) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379422.lg05
Chapter 8. Preventing Relapse After ECT: Maintenance ECT and Pharmacotherapy
(2019) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379422.lg08
Chapter 7. ECT Technique, Part II: Managing the Course of Treatments
(2019) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379422.lg07
(2019) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615379422.fm01
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Cognitive Performance in Patients with Depression Treated with Electroconvulsive Therapy
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- Authors
- Kessler, U., Schoeyen, H. K., Andreassen, O. A., Eide, G. E., Malt, U. F., Oedegaard, K. J., Morken, G., Sundet, K., & Vaaler, A. E.
- Affiliations
- Haukeland University Hospital (NO)
- Corresponding author
- Kessler, Ute
- ORCID
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2014-11-24
- Volume
- 75
- Issue
- 11
- Pages
- e1306-e1313
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W1985352874
- Cited by
- 84
- References
- 48
- Citations by year
- 2026: 6 · 2025: 4 · 2024: 3 · 2023: 5 · 2022: 5 · 2021: 5 · 2020: 9 · 2019: 18 · 2018: 9 · 2017: 5 · 2016: 7 · 2015: 8
- FWCI
- 5.09
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Universitetet i Bergen
- Universitetet i Oslo
- Haukeland Universitetssjukehus
- H. Lundbeck A/S
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- electroconvulsive therapy, bipolar depression, treatment-resistant depression, neurocognitive function, autobiographical memory, memory consistency, mood improvement
- MeSH terms
- Adult, Algorithms, Bipolar Disorder, Cognition Disorders, Electroconvulsive Therapy, Female, Humans, Male, Middle Aged, Treatment Outcome, Memory, Episodic, Depressive Disorder, Treatment-Resistant
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