ECCA's Turkish Validity and Reliability Study and Comparison With Other Cognitive Assessment Tests

Electroconvulsive therapy (ECT) is one of the oldest biological treatment methods used in psychiatry, based on inducing widespread seizures in the brain with externally applied controlled electrical currents. It was first applied in 1938 by Italian physician Ugo Cerletti and his assistant Lucio Bini. A 1974 report by the American Psychiatric Association stated that ECT was effective in treating depression, mania, and refractory schizophrenia, and it is still used today as an effective and safe method, particularly in the treatment of severe major depression, catatonia, schizophrenia, and mania. Although the exact mechanism of action of ECT is not fully understood, it is suggested that it increases brain receptor sensitivity, accelerates serotonin and dopamine metabolism, activates monoaminergic systems, regulates the circadian rhythm, and provides synchronization between brain hemispheres. In addition, it has been shown to affect neurotransmitter levels, neuroendocrine responses, and neurogenesis processes. Anterograde and retrograde amnesia are among the cognitive side effects that can be seen in the subacute phase of ECT. While anterograde amnesia usually resolves within a few months after treatment, retrograde amnesia can be permanent in some cases. Therefore, assessment of cognitive function before, during, and after ECT is recommended. In clinical practice, the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Test (MMSE) are frequently used for cognitive assessment. However, these scales were not developed to assess ECT-specific cognitive effects and may be limited in detecting retrograde memory loss, autobiographical memory impairments, and subjective memory complaints. Therefore, there is a need for more sensitive tools that can assess ECT-specific cognitive side effects. The Electroconvulsive Cognitive Assessment Test (ECCA), developed for this purpose by Adriana P. Hermida and colleagues from the Department of Psychiatry and Behavioral Sci