Overview
This submission is on behalf of ECT and related treatments committee of Royal College of Psychiatrists. The focus of this session is to present latest evidence on cognitive impairment in the context of ECT as an acute intervention as well as continuation/ maintenance treatment. including considering age as an important variable. Abstracts from three presentations are as follows:
• A propensity score analysis of retrograde amnesia following ECT (brief-pulse bitemporal and high-dose right unilateral) versus pharmacotherapy for depression which finds that patients with depression with no exposure to ECT experience substantial loss of autobiographical memory consistency (~25%) with passage of time. Percentage recall consistency is significantly reduced in both ECT groups compared to ECT-unexposed depressed controls at end-of-treatment and 3-month follow-up, more so in the bilateral ECT group
• A study of cumulative cognitive deficits after ECT which builds from 500 assessments with a battery of cognitive tests on patients receiving ECT in 2015 and reports on 1000 assessments currently using linear mixed-effect regression model to take account of age of patients, number of ECTs and level of depression, with some patients having multiple assessments over many years
• C/M ECT and cognition focuses on continuation ECT (C-ECT) and maintenance ECT (M-ECT) which are increasingly utilised to prevent relapses of major depression and schizophrenia where it is difficult to separate cognitive effects of ECT from the vagaries of the illness itself. Even so, there is limited yet high-quality evidence that indicates that clinical decision making to choose adding C-ECT to continuation pharmacotherapy in depression is not influenced by concerns regarding memory.
Objectives
- Understanding of cognitive impairment related to ECT.
- Exploring relationship between age, cognition and ECT.
- Differential impact of ECT on cognitive impairment based on utility of ECT as continuation/ maintenance treatment.
Speakers
Chair: Dr Raja Badrakalimuthu, Surrey and Borders Partnership NHS Foundation Trust, Guildford, Parliamentary and Healthcare Ombudsman Service, Dementia Carers Count, London
Professor Declan McLoughlin, Trinity College Dublin, Dublin
Professor George Kirov, Cardiff University, Cardiff
Associate Professor Prashanth Mayur, University of Sydney, Sydney, Westmead Institute of Medical Research, Westmead, St John of God Hospital, North Richmond, Cumberland Hospital, Westmead
