title: No change in neuropsychological dysfunction or emotional processing during treatment of major depression with cognitive-behaviour therapy or schema therapy.
abstract: BACKGROUND
  Impaired neuropsychological functioning is a feature of major depression. Previous studies have suggested that at least some aspects of neuropsychological functioning improve with successful treatment of major depression. The extent to which medications may affect the degree of normalization of these functions is unclear. The aim of the current study was to examine the course of neuropsychological functioning during treatment of major depression with cognitive-behaviour therapy (CBT) or schema therapy (ST).
  
  
  METHODS
  A total of 69 out-patients with a primary diagnosis of major depression and 58 healthy controls completed mood ratings, neuropsychological measures, and measures of emotional processing at baseline and after 16 weeks. Participants were randomized after baseline assessment to a year-long course of CBT or ST. Patients reassessed at 16 weeks were medication-free throughout the study.
  
  
  RESULTS
  Significant neuropsychological impairment was evident at baseline in depressed participants compared with healthy controls. After 16 weeks of psychotherapy, mean depression rating scores fell more than 50%. However, no neuropsychological measures showed convincing evidence of significant improvement and emotional processing did not change.
  
  
  CONCLUSIONS
  Persisting impairment in neuropsychological functioning after the first 16 weeks of CBT or ST suggests a need to modify psychological treatments to include components targeting cognitive functioning.
authors.affiliation: Department of Psychological Medicine,University of Otago,Christchurch,New Zealand.
authors.forename: R J
authors.initials: RJ
authors.lastname: Porter
authors.affiliation: Department of Psychological Medicine,University of Otago,Christchurch,New Zealand.
authors.forename: C
authors.initials: C
authors.lastname: Bourke
authors.affiliation: Department of Psychology,University of Canterbury,Christchurch,New Zealand.
authors.forename: J D
authors.initials: JD
authors.lastname: Carter
authors.affiliation: Department of Psychological Medicine,University of Otago,Christchurch,New Zealand.
authors.forename: K M
authors.initials: KM
authors.lastname: Douglas
authors.affiliation: Department of Psychological Medicine,University of Otago,Christchurch,New Zealand.
authors.forename: V V W
authors.initials: VV
authors.lastname: McIntosh
authors.affiliation: Department of Psychological Medicine,University of Otago,Christchurch,New Zealand.
authors.forename: J
authors.initials: J
authors.lastname: Jordan
authors.affiliation: Department of Psychological Medicine,University of Otago,Christchurch,New Zealand.
authors.forename: P R
authors.initials: PR
authors.lastname: Joyce
authors.affiliation: Department of Psychological Medicine,University of Otago,Christchurch,New Zealand.
authors.forename: C M A
authors.initials: CM
authors.lastname: Frampton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003071:Cognition; D015928:Cognitive Behavioral Therapy; D003865:Major Depressive Disorder / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011613:Psychotherapy; D055815:Young Adult
keywords: Facial emotion processing; major depressive disorder; memory; neuropsychological function; psychological treatment