title: Cognitive remediation for treatment-resistant depression: effects on cognition and functioning and the role of online homework.
abstract: Neurocognitive impairments are observed in depression and associated with poor functioning. This study examined the efficacy and the effectiveness of cognitive remediation with supplemental Internet-based homework in treatment-resistant depression. Participants were randomized to treatment or wait list control conditions. Treatment consisted of 10 weeks of weekly group sessions and daily online cognitive exercises completed at home. The participants were assessed on cognitive, mood, motivation, and functioning measures. There was a significant time by treatment interaction for attention/processing speed and verbal memory. Changes in functioning were not significant, although improved cognition predicted improvements in functioning. Number of minutes of online exercise was associated with greater cognitive improvements. Cognitive deficits are malleable with behavioral treatment in a mood disorder characterized by severe and persistent symptoms.
authors.affiliation: Department of Psychology, Queen's University, Kingston, Ontario, Canada. bowiec@queensu.ca
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Bowie
authors.forename: Maya
authors.initials: M
authors.lastname: Gupta
authors.forename: Katherine
authors.initials: K
authors.lastname: Holshausen
authors.forename: Ruzica
authors.initials: R
authors.lastname: Jokic
authors.forename: Michael
authors.initials: M
authors.lastname: Best
authors.forename: Roumen
authors.initials: R
authors.lastname: Milev
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology; D000328:Adult; D003072:Cognition Disorders / Q000209:etiology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000295:instrumentation / Q000379:methods*; D003865:Major Depressive Disorder / Q000150:complications / Q000628:therapy*; D061218:Depressive Disorder, Treatment-Resistant / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012917:Social Adjustment; D013997:Time Factors; D016896:Treatment Outcome