ReviewsCurrent Practices of Electroconvulsive Therapy in Mental Disorders A Systematic Review and Meta-Analysis of Short and Long-Term Cognitive EffectsLandry, Marilyne MD, MSc∗; Moreno, Alexander PhD†,‡; Patry, Simon MD, FRCPC∗,§,∥,¶; Potvin, Stephane PhD∗,∥; Lemasson, Morgane PhD∗,§,∥,# Author Information From the ∗Department of Psychiatry †Department of Psychology, Université de Montréal ‡Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Notre-Dame Hospital, CIUSSS du Centre-Sud-de-l'Île-de-Montréal §Centre d'excellence en électroconvulsivothérapie du Québec (CEECTQ), CIUSSS de l'Est-de-l'Île-de-Montréal ∥Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (IUSMM), CIUSSS de l'Est-de-l'Île-de-Montréal ¶Institut Universitaire en Santé Mentale de Québec (IUSMQ) #Bureau d'information et d'études en santé des populations, Institut national de santé publique du Quebec City, Quebec, Canada. Received for publication August 1, 2019; accepted July 31, 2020. Reprints: Marilyne Landry, MD, MSc, Department of Psychiatry, Université de Montréal, 2900 Boulevard Edouard-Montpetit, Montreal, Qc, Canada H3T 1J4 (e-mail: [email protected]). The authors have no conflicts of interest to report. In the last 3 years, S.P. has been a holder of grants from Otsuka Pharmaceuticals and HLS Therapeutics, which are unrelated to the current study. Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.ectjournal.com). The Journal of ECT: June 2021 - Volume 37 - Issue 2 - p 119-127 doi: 10.1097/YCT.0000000000000723 Buy SDC Metrics Abstract Electroconvulsive therapy (ECT) remains one of the most effective treatments for major depressive disorder, but uncertainties persist regarding the cognitive tests to include in ECT follow-up. The current study is a systematic review and meta-analysis of the most frequent cognitive side effects after ECT. We also discuss the most common cognitive tests in ECT follow-up. We searched studies published from 2000 to 2017 in English and French language in Pubmed, EBM Reviews, EMBASE, and PsycINFO. Standardized cognitive tests were separated into 11 cognitive domains. Comparisons between cognitive measures included pre-ECT baseline with post-ECT measures at 3 times: PO1, immediately post-ECT (within 24 hours after last ECT); PO2, short term (1–28 days); and PO3, long term (more than 1 month). A total of 91 studies were included, with an aggregated sample of 3762 individuals. We found no significant changes in global cognition with Mini-Mental State Examination at PO1. Hedges g revealed small to medium effect sizes at PO2, with individuals presenting a decrease in autobiographical memory, verbal fluency, and verbal memory. Verbal fluency problems showed an inverse correlation with age, with younger adults showing greater deficits. At PO3, there is an improvement on almost all cognitive domains, including verbal fluency and verbal memory. There is a lack of standardization in the choice of cognitive tests and optimal cognitive timing. The Mini-Mental State Examination is the most common screening test used in ECT, but its clinical utility is extremely limited to track post-ECT cognitive changes. Cognitive assessment for ECT purposes should include autobiographical memory, verbal fluency, and verbal memory. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.