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Autobiographical Memory and Electroconvulsive Therapy: Do Not Throw Out the Baby

Sackeim, Harold A. PhD

doi: 10.1097/YCT.0000000000000117

Retrograde amnesia for autobiographical information is the most critical adverse effect of electroconvulsive therapy (ECT). Much, if not most, modern research demonstrating long-term autobiographical amnesia after ECT has used either the Columbia University Autobiographical Memory Interview (CUAMI) or the short form of this scale (CUAMI-SF). Semkovska and McLoughlin claimed that studies using these instruments should be dismissed and the findings ignored owing to a lack of normative data, as well as concerns about the reliability and validity of these instruments. In this commentary, the development and use of these scales is reviewed. It is shown that Semkovska and McLoughlin’s critique is factually incorrect, as normative data were simultaneously collected in virtually all studies using these instruments. Furthermore, there is substantial evidence supporting the reliability and validity of these scales. Indeed, these instruments are the only neuropsychological tests repeatedly shown to covary with patient self-evaluations of ECT’s effects on memory and have repeatedly demonstrated long-term differences in the magnitude of amnesia as a function of ECT technique. Findings with the CUAMI and CUAMI-SF provide key evidence regarding ECT’s adverse cognitive effect profile. It is inaccurate and inadvisable to continue to deny that ECT can exert long-term adverse effects in this domain.

From the Departments of Psychiatry and Radiology, College of Physicians and Surgeons, Columbia University, New York, NY.

Received for publication November 7, 2013; accepted January 22, 2014.

Reprints: Harold A. Sackeim, PhD, Division of Geriatric Psychiatry, New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032 (e-mail:

The normative data reported here are available on request by e-mail to Dr. Sackeim.

H. A. Sackeim is a scientific consultant to Brainsway Inc, Cervel Neurotech, Inc, MECTA Corporation, Neuronetics Inc, and NeuroSync Inc.

© 2014 by Lippincott Williams & Wilkins