Evaluation of Short Term and Long Term Subjective and Objective Cognitive Outcomes Following ECT for Depression in a Naturalistic Ambulatory Setting: A Cohort Study

Clinically complex adults referred to ECT for depression presented with prominent memory concerns and performed below expectation compared to their estimated premorbid cognitive functioning at baseline. Naturalistic delivery of ECT did not appear to be associated with prolonged adverse cognitive outcomes; however, subjective memory concerns and below-expected cognitive performance persisted during follow-up. Treatment response impacted subjective memory outcomes, with only 'Responders' endorsing slightly reduced, though still persistent, subjective memory concerns following ECT. Conclusions on the long-term impacts of ECT are tempered by the high lost to follow up (LTFU) rate observed across follow-up assessments (66% LTFU at 6-months, 81% LTFU at 12-months). Nonetheless, these findings emphasize the need to address subtle cognitive deficits and memory complaints that persist following ECT, even in individuals demonstrating clinical improvement.