PMID- 37159469
OWN - NLM
STAT- MEDLINE
DCOM- 20230511
LR  - 20230511
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 18
IP  - 5
DP  - 2023
TI  - Predictors of cognitive changes in patients with schizophrenia undergoing 
      electroconvulsive therapy.
PG  - e0284579
LID - 10.1371/journal.pone.0284579 [doi]
LID - e0284579
AB  - INTRODUCTION: Previous studies on the effects of electroconvulsive therapy (ECT) 
      on cognition in schizophrenia have been inconclusive. This study aimed to 
      identify factors that may predict cognitive improvement or deterioration in 
      patients with schizophrenia after-ECT. MATERIALS & METHODS: Patients with 
      schizophrenia or schizoaffective disorder with predominantly positive psychotic 
      symptoms, who were treated with ECT at the Institute of Mental Health (IMH), 
      Singapore, between January 2016 and January 2018, were assessed. Montreal 
      Cognitive Assessment (MoCA), Brief Psychiatric Rating Scale (BPRS) and Global 
      Assessment of Function (GAF) were performed before and after ECT. Patients with 
      clinically significant improvement, deterioration or no change in MoCA scores 
      were compared on demographics, concurrent clinical treatment and ECT parameters. 
      RESULTS: Of the 125 patients analysed, 57 (45.6%), 36 (28.8%) and 32 (25.6%) 
      showed improvements, deterioration and no change in cognition respectively. Age 
      and voluntary admission predicted MoCA deterioration. Lower pre-ECT MoCA and 
      female sex predicted MoCA improvement. Patients showed improvements in GAF, BPRS 
      and BPRS subscale scores on average, except for the MoCA deterioration group, who 
      did not show statistically significant improvement in negative symptom scores. 
      Sensitivity analysis showed that nearly half the patients (48.3%) who were 
      initially unable to complete MoCA pre-ECT were able to complete MoCA post-ECT. 
      CONCLUSIONS: The majority of patients with schizophrenia demonstrate improved 
      cognition with ECT. Patients with poor cognition pre-ECT are more likely to see 
      improvement post-ECT. Advanced age may be a risk factor for cognitive 
      deterioration. Finally, improvements in cognition may be associated with 
      improvements in negative symptoms.
CI  - Copyright: (c) 2023 Rajagopalan et al. This is an open access article distributed 
      under the terms of the Creative Commons Attribution License, which permits 
      unrestricted use, distribution, and reproduction in any medium, provided the 
      original author and source are credited.
FAU - Rajagopalan, Arvind
AU  - Rajagopalan A
AUID- ORCID: 0000-0002-9558-4605
AD  - Department of Mood and Anxiety, Institute of Mental Health, Singapore, Singapore.
FAU - Lim, Kenny Wai Kwong
AU  - Lim KWK
AUID- ORCID: 0000-0002-7808-8132
AD  - Department of Mood and Anxiety, Institute of Mental Health, Singapore, Singapore.
FAU - Tan, Xiao Wei
AU  - Tan XW
AD  - Department of Mood and Anxiety, Institute of Mental Health, Singapore, Singapore.
FAU - Martin, Donel
AU  - Martin D
AD  - School of Psychiatry, Black Dog Institute, University of New South Wales, Sydney, 
      Australia.
FAU - Lee, Jimmy
AU  - Lee J
AD  - Department of Psychosis, Institute of Mental Health, Singapore, Singapore.
AD  - Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, 
      Singapore.
FAU - Tor, Phern-Chern
AU  - Tor PC
AD  - Department of Mood and Anxiety, Institute of Mental Health, Singapore, Singapore.
LA  - eng
PT  - Journal Article
DEP - 20230509
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Humans
MH  - Female
MH  - *Schizophrenia/complications/therapy
MH  - *Electroconvulsive Therapy/adverse effects
MH  - *Psychotic Disorders/complications/therapy
MH  - Academies and Institutes
MH  - Cognition
PMC - PMC10168561
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/05/09 18:41
MHDA- 2023/05/11 06:42
PMCR- 2023/05/09
CRDT- 2023/05/09 13:34
PHST- 2022/08/29 00:00 [received]
PHST- 2023/04/02 00:00 [accepted]
PHST- 2023/05/11 06:42 [medline]
PHST- 2023/05/09 18:41 [pubmed]
PHST- 2023/05/09 13:34 [entrez]
PHST- 2023/05/09 00:00 [pmc-release]
AID - PONE-D-22-24095 [pii]
AID - 10.1371/journal.pone.0284579 [doi]
PST - epublish
SO  - PLoS One. 2023 May 9;18(5):e0284579. doi: 10.1371/journal.pone.0284579. 
      eCollection 2023.