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A Brief Measure for Assessing Patient Perceptions of Cognitive Side Effects After Electroconvulsive Therapy: The Subjective Assessment of Memory Impairment

Kumar, Divya Rani; Han, Hank Ke AIN; Tiller, John MD, MBChB, BSc, DPM, FRACP, FRANZCP, GAICD; Loo, Colleen K. MBBS, MD, FRANZCP; Martin, Donel M. PhD

doi: 10.1097/YCT.0000000000000329
Original Studies

Objectives Directly inquiring about patient experiences of memory problems after ECT may alert clinicians to the existence of treatment side effects and provide an impression of their intrusiveness. In this study, we examined use of a novel and brief patient-reported measure to assess perceptions of memory side effects and their functional consequences before and after an acute ECT treatment course. These outcomes were compared with objective cognitive and subjective quality of life measures.

Methods Data for 75 patients who were prescribed an acute course of ECT were analyzed. Subjective and objective measures were assessed before ECT (pretreatment) and at posttreatment. Patient perceptions were assessed using the Subjective Assessment of Memory Impairment, which consists of two items: The Memory Problems item, and The Impact of Cognitive Adverse Events item. Objective cognitive outcomes were assessed using the Montreal Cognitive Assessment. Quality of life was assessed using the Quality of Life Enjoyment and Satisfaction Questionnaire—Short Form.

Results Patient perceptions of their memory problems did not change across the ECT course, and their functional impact were considered less intrusive after ECT. Greater functional impact of memory impairment was related to poorer quality of life at posttreatment, but not at pretreatment. Subjectively rated cognitive functioning was not associated with objective cognitive outcomes.

Conclusions The Subjective Assessment of Memory Impairment is a brief tool for measuring patient-rated memory function. Overall, patients did not report any change in subjective memory problems after ECT. Although perceptions of functional memory impairment and quality of life were related after ECT, there was no association with objectively assessed cognitive outcomes.

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From the *Faculty of Medicine, University of New South Wales; †School of Psychiatry, Black Dog Institute, University of New South Wales; ‡Wesley Hospital, Sydney; §Emeritus of Psychiatry, The University of Melbourne; ∥Albert Road Clinic, Melbourne; ¶School of Psychiatry, University of New South Wales; #Sydney Neurostimulation Centre, Black Dog Institute; **ECT, Wesley Hospital; ††St George Hospital, South Eastern Sydney Health, Sydney, Australia.

Received for publication October 5, 2015; accepted April 7, 2016.

Reprints: Donel M. Martin, PhD, Black Dog Institute, Hospital Rd, Randwick, NSW 2031, Australia (e-mail:

The authors have no conflicts of interest or financial disclosures to report.

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