Trajectories of Efficacy and Cognitive Function During Electroconvulsive Therapy Course in Young Adults with Treatment-Resistant Depression

Shu-Xian Xu; Xin-Hui Xie; Lihua Yao; Li-Chang Chen; Qirong Wan; Zhen-Hua Chen; Zhongchun Liu

doi:10.2147/NDT.S394155

Trajectories of Efficacy and Cognitive Function During Electroconvulsive Therapy Course in Young Adults with Treatment-Resistant Depression

Neuropsychiatr Dis Treat. 2023 Jan 29:19:267-281. doi: 10.2147/NDT.S394155. eCollection 2023.

Authors

Shu-Xian Xu^#¹, Xin-Hui Xie^#¹, Lihua Yao¹, Li-Chang Chen², Qirong Wan¹, Zhen-Hua Chen¹, Zhongchun Liu^{1

3}

Affiliations

¹ Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, People's Republic of China.
² Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China.
³ Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, People's Republic of China.

^# Contributed equally.

Abstract

Objective: Little is known about the effectiveness and cognitive side-effects of electroconvulsive therapy (ECT) in young adults with treatment-resistant depression (TRD). The primary aim of this prospective longitudinal observational trial was to examine the clinical features and cognitive outcomes of young adults with TRD undergoing ECT.

Methods: Changes in depressive symptoms and objective and subjective cognitive function were assessed using repeated evaluation at baseline, after each ECT session, and at one-month follow-up using the Montgomery-Äsberg Depression Rating Scale (MADRS) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Forward Digital Span Test (FDST), and part of the Columbia Subjective Side Effects Schedule.

Results: Of 41 inpatients, 35 (85.4%) and 12 (29.3%) met the criteria for response and remission after ECT, respectively. The greatest clinical improvements occurred during the first 3-4 ECT sessions. While 34 patients reported subjective cognitive impairment increased with ECT, immediate and delayed memory (RBANS) significantly increased after ECT, consistent with FDST results. Objective cognition significantly improved during follow-up, but subjective cognition remained impaired.

Conclusion: ECT is effective in young adults with TRD. Although subjective cognitive impairment increased during treatment, objective cognitive impairments were not observed.

Keywords: cognitive function; electroconvulsive therapy; treatment-resistant depression; young adults.

Grants and funding

This work was supported by grants from the National Natural Science Foundation of China (grant number: U21A20364) and the National Key R&D Program of China (grant number: 2018YFC1314600).