PREDICTORS OF RETROGRADE-AMNESIA FOLLOWING ECT

Objective: Substantial progress has been made in identifying how the t reatment parameters used in ECT impact on cognitive side effects. Howe ver, there is limited information regarding individual differences in vulnerability to these side effects. The authors examined patients' pr etreatment global cognitive status and postictal orientation recovery time as potential predictors of the magnitude of retrograde amnesia fo r autobiographical memories after ECT. Method: Seventy-one inpatients with major depressive disorder were randomly assigned to four ECT cond itions that varied in electrode placement (right unilateral versus bil ateral) and stimulus dosage (low versus high intensity). Orientation r ecovery time was assessed at virtually every session during the course off CT. Global cognitive status was assessed with the modified Mini-M ental State examination before treatment, during the week after termin ation of treatment, and 2 months after treatment ended. Retrograde amn esia was assessed at these same time points with the Autobiographical Memory Interview. Results: Pre-ECT global cognitive status and the dur ation of postictal disorientation were strong predictors of the magnit ude of retrograde amnesia in the week after the course of ECT and at 2 -month follow-up. In general, these relationships were maintained rega rdless of technical parameters in the administration of the ECT. Concl usions: Patients who manifest global cognitive impairment before treat ment and patients who experience prolonged disorientation in the acute postictal period may be the most vulnerable to persistent retrograde amnesia for autobiographical information.