Skip to main content
×
Home
    • Aa
    • Aa

Successful computer-assisted cognitive remediation therapy in patients with unipolar depression: a proof of principle study

  • SAFA ELGAMAL (a1), MARGARET C. McKINNON (a1), KARUNA RAMAKRISHNAN (a1), RUSSELL T. JOFFE (a2) and GLENDA MacQUEEN (a1)...
Abstract
ABSTRACTBackground

Despite increasing awareness of the extent and severity of cognitive deficits in major depressive disorder (MDD), trials of cognitive remediation have not been conducted. We conducted a 10-week course of cognitive remediation in patients with long-term MDD to probe whether deficits in four targeted cognitive domains, (i) memory, (ii) attention, (iii) executive functioning and (iv) psychomotor speed, could be improved by this intervention.

Method

We administered a computerized cognitive retraining package (PSSCogReHab) with demonstrated efficacy to 12 stable patients with recurrent MDD. Twelve matched patients with MDD and a group of healthy control participants were included for comparison; neither comparator group received the intervention that involved stimulation of cognitive functions through targeted, repetitive exercises in each domain.

Results

Patients who received cognitive training improved on a range of neuropsychological tests targeting attention, verbal learning and memory, psychomotor speed and executive function. This improvement exceeded that observed over the same time period in a group of matched comparisons. There was no change in depressive symptom scores over the course of the trial, thus improvement in cognitive performance occurred independent of other illness variables.

Conclusions

These results provide preliminary evidence that improvement of cognitive functions through targeted, repetitive exercises is a viable method of cognitive remediation in patients with recurrent MDD.

Copyright
Corresponding author
*Address for correspondence: G. MacQueen, M.D., Ph.D., St Joseph's Center for Mental Health Services, D1, Mood Disorders Program, 100 West 5th St, Hamilton, ON, CanadaL8N 3K7. (Email: macqueng@mcmaster.ca)
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

M. Bell , G. Bryson , T. Greig , C. Corcoran & B. E. Wexler (2001). Neurocognitive enhancement therapy with work therapy: effects on neuropsychological test performance. Archives of General Psychiatry 58, 763768.

M. Bell , G. Bryson & B. E. Wexler (2003). Cognitive remediation of working memory deficits: durability of training effects in severely impaired and less severely impaired schizophrenia. Acta Psychiatrica Scandinavica 108, 101109.

J. M. Fiszdon , G. J. Bryson , B. E. Wexler & M. D. Bell (2004). Durability of cognitive remediation training in schizophrenia: performance on two memory tasks at 6-month and 12-month follow-up. Psychiatry Research 125, 17.

P. Fossati , A. M. Ergis & J. F. Allilaire (2002). Executive functioning in unipolar depression: a review. Encephale 28, 97107.

P. Fossati , P. O. Harvey , G. Le Bastard , A. M. Ergis , R. Jouvent & J. F. Allilaire (2004). Verbal memory performance of patients with a first depressive episode and patients with unipolar and bipolar recurrent depression. Journal of Psychiatric Research 38, 137144.

M. Garcia-Toro , J. A. Talavera , E. Gonzalez , P. Tejada , C. Blanco , A. Gonzalez & J. Saiz-Ruiz (2003). Audioverbal cognitive dysfunction in depression. Factors involved. Progress in Neuropsychopharmacologyy and Biological Psychiatry 27, 3742.

M. Gorlyn , J. G. Keilp , M. A. Oquendo , A. K. Burke , H. A. Sackeim & M. J. John (2006). The WAIS-III and major depression: absence of VIQ/PIQ differences. Journal of Clinical and Experimental Neuropsychology 28, 11451157.

M. Hamilton (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry 23, 5662.

P. O. Harvey , G. Le Bastard , J. B. Pochon , R. Levy , J. F. Allilaire , B. Dubois & P. Fossati (2004). Executive functions and updating of the contents of working memory in unipolar depression. Journal of Psychiatric Research 38, 567576.

G. E. Hogarty , S. Flesher , R. Ulrich , M. Carter , D. Greenwald , M. Pogue-Geile , M. Kechavan , S. Cooley , A. L. DiBarry , A. Garrett , H. Parepally & R. Zoretich (2004). Cognitive enhancement therapy for schizophrenia: effects of a 2-year randomized trial on cognition and behavior. Archives of General Psychiatry 61, 866876.

R. C. Kessler , H. S. Akiskal , M. Ames , H. Birnbaum , P. Greenberg , R. M. A. Hirschfield , R. Jin , K. R. Merikangas , G. E. Simon & P. S. Wang (2006). Prevalence and effects of mood disorders on work performance in a nationally representative sample of U.S. workers. American Journal of Psychiatry 163, 15611568.

I. K. Lampe , M. M. Sitskoorn & T. J. Heeren (2004). Effects of recurrent major depressive disorder on behavior and cognitive function in female depressed patients. Psychiatry Research 125, 7379.

N. I. Landro , T. C. Stiles & H. Sletvold (2001). Neuropsychological function in nonpsychotic unipolar major depression. Neuropsychiatry, Neuropsychology, and Behavioral Neurology 14, 233240.

B. Levine , I. H. Robertson , L. Clare , G. Carter , J. Hong , B. A. Wilson , J. Duncan & D. T. Stuss (2000). Rehabilitation of executive functioning: an experimental-clinical validation of goal management training. Journal of the International Neuropsychological Society 6, 299312.


G. M. MacQueen , S. Campbell , B. S. McEwen , K. Macdonald , S. Amano , R. T. Joffe , C. Nahmias & L. T. Young (2003). Course of illness, hippocampal function, and hippocampal volume in major depression. Proceedings of the National Academy of Sciences USA 100, 13871392.


M. M. Mesulam (2002). The human frontal lobes: transcending the default mode through contingent encoding. In Principles of Frontal Lobe Function (ed. D. T. Stuss and R. Knight ), pp. 830. Oxford University Press: New York.

Y. Paelecke-Habermann , J. Pohl & B. Leplow (2005). Attention and executive functions in remitted major depression patients. Journal of Affective Disorders 89, 125135.

S. Paradiso , G. J. Lamberty , M. J. Garvey & R. G. Robinson (1997). Cognitive impairment in the euthymic phase of chronic unipolar depression. Journal of Nervous and Mental Disease 185, 748754.

I. H. Robertson & J. M. Murre (1999). Rehabilitation of brain damage: brain plasticity and principles of guided recovery. Psychological Bulletin 125, 544575.

L. N. Robins & D. A. Regier (eds) (1990). Psychiatric Disorders in America: The Epidemiologic Catchment Area Study. The Free Press: New York.

H. L. Roediger & K. B. McDermot (1992). Depression and implicit memory: a commentary. Journal of Abnormal Psychology 101, 587591.

R. M. Ruff & C. C. Allen (1996). Ruff 2&7 Selective Attention Test. Professional Manual. Psychological Assessment Resources: Odessa, FL.

T. A. Salthouse (2006). Mental exercise and mental aging. Perspectives on Psychological Science 1, 6887.

M. C. Sevigny , J. Everett & S. Grondin (2003). Depression, attention, and time estimation. Brain and Cognition 53, 351353.

K. I. Stordal , A. J. Lundervold , J. Egeland , A. Mykletun , A. Asbjornsen , N. I. Landro , A. Roness , B. R. Rund , K. Sundet , K. J. Oedegaard & A. Lund (2004). Impairment across executive functions in recurrent major depression. Nordic Journal of Psychiatry 58, 4147.

T. Ueland & B. R. Rund (2004). A controlled randomized treatment study: the effects of a cognitive remediation program on adolescents with early onset psychosis. Acta Psychiatrica Scandinavica 109, 7074.

G. M. van der Gaag , R. S. Kern , R. J. van den Bosch & R. P. Liberman (2002). A controlled trial of cognitive remediation in schizophrenia. Schizophrenia Bulletin 28, 167176.

H. O. Veiel (1997). A preliminary profile of neuropsychological deficits associated with major depression. Journal of Clinical and Experimental Neuropsychology 19, 587603.

D. Wechsler (1997). Wechsler Adult Intelligence Scale (3rd edn). The Psychological Corporation: San Antonio, TX.

S. L. Willis , S. L. Tennstedt , M. Marsiske , K. Ball , J. Elias , K. M. Koepke , J. N. Morris , G. W. Rebok , F. W. Unverzagt , A. M. Stoddard & E. Wright ; ACTIVE Study Group (2006). Long-term effects of cognitive training on everyday functional outcomes in older adults. Journal of the American Medical Association 296, 28052814.

G. Winocur , M. Moscovitch , S. Fogel , R. S. Rosenbaum & M. Sekeres (2005). Preserved spatial memory after hippocampal lesions: effects of extensive experience in a complex environment. Nature Neuroscience 8, 273275.

R. C. Young , J. T. Biggs , V. E. Ziegler & D. A. Meyer (1978). A rating scale for mania: reliability, validity and sensitivity, British Journal of Psychiatry 133, 429435.

K. K. Zakzanis , L. Leach & E. Kaplan (1998). On the nature and pattern of neurocognitive function in major depressive disorder. Neuropsychiatry, Neuropsychology, and Behavioral Neurology 11, 111119.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×