The ElectroConvulsive Therapy Cognitive Assessment (ECCA)

INTRODUCTION: The ElectroConvulsive therapy Cognitive Assessment (ECCA) was designed to monitor specific cognitive domains commonly altered in ECT. We describe the properties of a Spanish version of the ECCA (ECCA-S). MATERIALS AND METHODS: The ECCA-S and the Mini-Mental State Examination (MMSE) were administered pre-ECT course, at the sixth treatment, and post-ECT course to 72 subjects with a major depressive episode undergoing acute ECT. At a single time point, the ECCA-S and MMSE were also administered to 26 healthy controls and to 59 subjects who experienced a depressive episode but did not receive ECT. RESULTS: Across the 3 testing time points, changes in ECCA-S scores were statistically different, whereas MMSE scores did not show statistically significant differences throughout ECT. There was poor agreement between both tests, particularly at mid-ECT and post-ECT. Informant-assessed memory, autobiographical memory, and delayed recall decreased significantly throughout treatment. Attention and subjective memory decreased at the sixth ECT (P>0.05). The number of ECT sessions influenced ECCA-S scores. ECCA-S exhibited good inter-rater reliability in depressive patients and healthy controls. CONCLUSIONS: The ECCA-S is a practical bedside screening tool for Spanish speakers to monitor cognitive side effects of ECT in routine clinical practice. Unlike the MMSE, the ECCA-S is sensitive to cognitive changes throughout the course of ECT, making it a valuable resource for clinicians.