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ECT Cognitive Effects — MRCPsych Paper B MCQ

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ModerateMood DisordersECT Cognitive EffectsMRCPsych Paper B

A 55-year-old man with recurrent severe depression responds well to a course of bilateral electroconvulsive therapy (ECT). After treatment, he reports gaps in his memory for personal events occurring during the weeks before the ECT course. Which statement most accurately reflects the information he should be given about this problem?

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Reveal the answer and explanation

Correct answer: D — It is a recognised effect; memories may return fully or partly, but some autobiographical gaps can persist

Retrograde loss of autobiographical memories is a recognised cognitive adverse effect of ECT. Memories from around the illness and treatment period may return fully or partly, but some gaps can persist. Bilateral ECT generally has a greater effect on memory than unilateral ECT. This is distinct from the brief confusion or disorientation immediately after treatment, so A is incorrect. Depression itself can impair cognition, but the described temporal pattern is a recognised ECT effect, making C inappropriate. ECT has not been shown to cause structural brain damage or increase dementia risk, excluding D. Option B reverses the relative cognitive effects of bilateral and unilateral electrode placement.

Reference: Royal College of Psychiatrists. Electroconvulsive therapy (ECT), sections 'Are there different types of ECT?' and 'Long-term side effects', March 2022. https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/ect