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Tuesday, July 3, 2007

Complaints of loss of personal memories after ECT: evidence of a somatoform disorder?

Memory complaints after ECT a somatoform disorder . This needs some explanation. It is the title of an article by Prof M. Fink. A very distinguished physician with a tremendous amount of experience with ECT. In this article he summarizes the complaints of two patients treated successfully with ECT. They both have expressed their memory loss with great detail in the media and even psychiatric congresses. He also mentions Kitty Dukakis and her new published book and DVD: Shock.
The author doesn't deny memory loss can occur after ECT but not to the extend as noted by the examples he mentions in this article. In his article he makes a case for defining these extraordinary cases with extensive personal memory loss as a somatoform disorder. This is a disorder consisting of unexplained physical complaints, inconsistent with known anatomy, physiology, or biology. According to the author:

The rare complaints of persistent loss of personal memories as a consequence of ECT are well within the family of these syndromes.
The demographic features of the complainants according to the author are well educated women, often nurses, with histories of prolonged depressive illness marked by somatic features and suicidal episodes. ECT was the last resort, reluctantly advised and administered, that resulted in relief of depression. The loss of personal memories is a new focus of illness making return to work impossible, however these patients function well in new roles as critics of psychiatry.
I don't know, I can recognize his arguments but the problem is as stated in an earlier article that we do not know enough about the possible causes of memory loss. By that I mean the possibility that some patients are more vulnerable for this side effect. Vulnerable in a biological sense and the patients he describes could well be the ones we are looking for but we need better understanding of the etiology for discovery of high risk groups.

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