Autobiographical memory and depression: Effects of ECT

Abstract

An Autobiographical memory Interview (AMI) was administered to 66 depressed inpatients and 22 nondepressed matched control subjects. Patients were randomized to 1 of 4 forms of electroconvulsive therapy (ECT) that varied in electrode placement and stimulus intensity: low, moderate, or high dose right unilateral, or moderate bilateral. Short-term retrograde amnesia was assessed using the AMI during the week following randomized ECT. Bilateral ECT produced more marked deficits than any of the unilateral conditions. High dose unilateral ECT was more efficacious than the two other unilateral conditions and was equal in efficacy to moderate bilateral ECT. Patients who did not respond to the randomized phase of ECT were treated in an open, crossover phase using moderate dose bilateral ECT. At two months following all ECT, persistent amnestic deficits were related to having received a second ECT course and, to a lesser extent, bilateral ECT during the randomized phase. Enduring deficits were found at six months following all ECT. These long-term deficits were related to being treated with bilateral ECT versus unilateral ECT. These findings have important implications for the theory and practice of ECT.