AccScience Publishing / JCBP / Online First / DOI: 10.36922/JCBP025360068
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ORIGINAL RESEARCH ARTICLE

Improvement of effortful cognition through modified electroconvulsive therapy in treatment-resistant depression

Luoan Wu1 ,  Wei Li1 ,  Xinyu Wang2 ,  Yifan Sun2 ,  Wenliang Wang2* ,  Yu Li1*
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1 Department of Psychiatry, The Yixing Fifth People’s Hospital, Yixing, Jiangsu, China
2 Department of Psychiatry, The Affiliated Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
JCBP, 025360068 https://doi.org/10.36922/JCBP025360068
Received: 2 September 2025 | Revised: 25 September 2025 | Accepted: 10 October 2025 | Published online: 28 October 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Modified electroconvulsive therapy (MECT) is widely used in clinical practice and has become an indispensable treatment for treatment-resistant depression (TRD). This study explores the influence of MECT on effortful cognition in TRD using the face-vignette task (FVT). A total of 31 TRD patients and 30 healthy controls (HCs) were recruited. TRD patients were treated with MECT, and their depression severity was measured using the Hamilton depression rating scale (HAMD) and the FVT. Measurements were taken at 4 time points: baseline 1 (within 1 day before the first MECT session), baseline 2 (within 1 day after the completion of 12 MECT sessions), 2 weeks (after 2 weeks of MECT treatment), and 4 weeks (after 4 weeks of MECT treatment). HCs completed the FVT once. At baseline 1, all subjects completed the Basic Facial Emotion Identification Test; performance did not differ between the TRD and HC groups. However, MECT reduced HAMD scores in the TRD group. Additionally, at baseline 1, HCs showed a higher vignette-response proportion and a lower face-response proportion than TRD patients. In the TRD group, the face-response proportion at 4 weeks was lower, while the vignette-response proportion was higher than that at baseline 1, baseline 2, and 2 weeks. MECT improved FVT performance in the TRD group. TRD patients exhibited impairments in effortful cognition, which may improve following MECT. Effort cognitive indicators may serve as potential indices for evaluating the therapeutic effects of MECT in TRD.

Keywords
Treatment-resistant depression
Modified electroconvulsive therapy
Effortful cognition
Face-vignette task
Funding
This study is supported by the General Scientific Research Program of Wuxi Municipal Health Commission (No. M202458).
Conflict of interest
The authors declare no conflict of interest.
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Journal of Clinical and Basic Psychosomatics, Electronic ISSN: 2972-4414 Print ISSN: 3060-8562, Published by AccScience Publishing
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