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


METHODS
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.
Elgamal
Safa
S
McMaster University, Hamilton, Ontario, Canada.
McKinnon
Margaret C
MC
Ramakrishnan
Karuna
K
Joffe
Russell T
RT
MacQueen
Glenda
G
D000328:Adult; D001288:Attention; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D008570:Memory, Short-Term; D008875:Middle Aged; D009483:Neuropsychological Tests; D011214:Practice, Psychological; D011340:Problem Solving; D011930:Reaction Time; D012073:Remedial Teaching / Q000379:methods*; D012153:Retention, Psychology; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome