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Subjective and objective memory effects after electroconvulsive therapy for depressive disorders - systematic review and meta-analysis

Verspecht S, Vansteelandt K, Obbels J, Mercier T, Denayer N, Van den Eynde L, Laroy M, Hebbrecht K et al.

Journal of psychiatric research, 2026

837 participants

Abstract

Introduction: Both objective and subjective memory functioning may be affected by electroconvulsive therapy (ECT). However, the relationship between objectively measured memory performance and subjective memory complaints has not been systematically examined.

Methods: PubMed, Embase, Web of Science, Scopus, CINAHL were searched for studies of patients with a major depressive episode treated with ECT, assessing both subjective and objective memory, before and after an ECT course. Four separate meta-analyses examined the change within subjects in immediate recall, delayed recall, and autobiographical memory and subjective memory functioning.

Results: Twelve studies involving 837 participants were included. Within one month post-ECT, weighted effect sizes (ESs) indicated no significant change in immediate recall, a significant decline in delayed recall and autobiographical memory, and a significant improvement in subjective memory. Beyond one month post-ECT, immediate and delayed recall significantly improved, autobiographical memory significantly declined while subjective memory significantly improved. Substantial heterogeneity remained across all meta-analyses despite sensitivity and moderator analyses. Moderator analysis indicated that average mood improvement was not associated with ESs for subjective memory within one month post-ECT, but was associated with them thereafter. Studies with a larger decline in autobiographical memory showed a smaller improvement in subjective…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 837 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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