Cognitive function changes during a course of electroconvulsive therapy in patients with various psychiatric illnesses: A prospective observational study.

Abstract

Background: Electroconvulsive therapy (ECT) is an effective treatment for severe psychiatric disorders, but concerns about cognitive side effects persist.

Aim: To assess cognitive function changes during ECT in patients with various psychiatric illnesses.

Materials and methods: This prospective observational study included 100 patients (aged 18-60 years) with psychiatric disorders scheduled for ECT at a tertiary care hospital. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) at four-time points: before and after the first ECT session, and before and after the third ECT session. The first and third sessions were chosen to capture both acute effects and short-term cumulative changes. Socio-demographic and clinical data were collected using a semi-structured proforma.

Results: The sample comprised patients with schizophrenia (50%), bipolar disorder (22%), major depressive disorder (21%), and obsessive-compulsive disorder (OCD) (7%). Baseline cognitive impairment was observed in 96% of patients. After the third ECT session, there was a significant improvement in the naming domain (P = 0.003) and a trend towards improvement in overall cognitive function (P = 0.075). Patients with schizophrenia and bipolar disorder showed more significant improvements in cognitive function compared to those with other diagnoses. Education level was significantly associated with cognitive outcomes (P = 0.004), with higher education correlating with better cognitive performance.

Conclusion: This study suggests that ECT does not lead to significant cognitive decline in the short term and may improve certain cognitive domains, particularly naming ability. The cognitive effects of ECT vary across different psychiatric diagnoses and are influenced by educational background.