Subjective and objective memory effects after electroconvulsive therapy for depressive disorders - systematic review and meta-analysis.
Shauni Verspecht, Kristof Vansteelandt, Jasmien Obbels et al.
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In 30 seconds
This systematic review and meta-analysis examined changes in objective and subjective memory after electroconvulsive therapy (ECT) for major depressive episodes. Twelve studies involving 837 participants assessed memory before and after an ECT course. Within one month, immediate recall showed no significant change, delayed recall and autobiographical memory declined, and subjective memory improved. Beyond one month, immediate and delayed recall improved, autobiographical memory remained reduced, and subjective memory improved. The analyses found substantial heterogeneity, and study-level associations between autobiographical memory decline and subjective memory improvement do not establish patient-level relationships.
Key findings
- Across 12 studies involving 837 participants, immediate recall did not change significantly within one month after ECT.
- Within one month post-ECT, delayed recall and autobiographical memory declined significantly, while subjective memory improved significantly.
- Beyond one month, immediate and delayed recall improved significantly; autobiographical memory declined and subjective memory improved significantly.
- Larger study-level declines in autobiographical memory were associated with smaller subjective memory improvements immediately after ECT, but not beyond one month.
Why it matters
The findings show that memory outcomes after ECT differ by domain and assessment period: subjective memory may improve even when autobiographical memory declines. Distinguishing these outcomes can help clinicians interpret cognitive assessments and patient-reported memory changes without assuming they measure the same effects. The substantial heterogeneity and study-level nature of the associations warrant caution in applying average patterns to individual patients.
What to keep in mind
Substantial heterogeneity remained across all meta-analyses. The reported associations were at the study level and do not necessarily reflect relationships within individual patients.