Patients' perspectives on electroconvulsive therapy: a reevaluation of the review by Rose et al on memory loss after electroconvulsive therapy.

Objectives In 2003, based on a review of 7 studies, Rose et al concluded that at least one third of patients report significant memory loss 6 months or more after electroconvulsive therapy (ECT). However, few details on the included studies were given. The present study evaluates factors that may have influenced the results. Methods The 7 studies were scrutinized as to the 6-month assessment criterion, whether the data represent ECT-treated patients in general, specification and significance of the memory loss, stimulus type, and electrode placement. Results In 3 studies, the 6-month inclusion criterion was not met, including 1 study with 98% satisfied patients and 1 study with only 37% valid response rate. Two other studies selected individuals from user/advocacy groups generally biased against ECT and were probably overlapping. The significance of memory problems was not mentioned in any of the studies. Two studies reported that 30% and 55% of patients treated with bilateral ECT in the 1970s felt they had persistent memory gaps around the time of treatment, but the long-obsolete sine wave stimulus type was used. The results mostly concerned bilateral ECT, whereas unilateral ECT seemed to cause little complaints. Conclusions Data used by Rose et al are severely flawed, making their results inconclusive and misleading.