Design: Our aim was to study the long-term effects of electroconvulsive therapy (ECT) in depression. A total of 55 patients were followed-up 20 to 24 years after an ECT series; 13 patients were still alive, and 10 agreed to participate in the study. All 55 patients had been investigated with clinical and neuropsychological assessment and with neurophysiological measurements and with regional cerebral blood flow (rCBF) and EEG before the first ECT, 6 months later, and after approximately 1 year. These investigations were repeated in the 10 patients.
Results: Before the original ECT series, all patients had suffered from severe mood disorder. At follow-up, the 10 patients showed no clear signs of mood disorder or cognitive impairment. There was a slightly subnormal performance in working memory and in verbal as well as visual episodic memory on all 3 occasions after the ECT series. The rCBF measurement showed a significant average CBF decrease from the first to the last measurement. There was, moreover, a significant rCBF decrease in frontal areas at the last measurement compared with the 3 previous assessments.
Conclusion: All ten patients followed-up 20 to 24 years after an ECT series were mentally healthy and thus besides a moderate visual memory dysfunction, no severe side effects were observed with clinical and neuroimaging techniques.