Cognitive remediation therapy for patients with depression
Final Report Abstract
Our study is the first to evaluate an individualized vs. generalized cognitive remediation therapy (CRT) in patients with partially remitted depression. Using a high quality single blinded, randomized controlled design we were able to show that CRT is effective in improving attention and subjective psychosocial performance in (partially) remitted MDD patients who still complain of cognitive deficits. Our study showed that CRT was a well-accepted intervention, which not only lead to a significant improvement of attention performances, but also potentially transferred this improvement into real-life as measured by the self-assessed psychosocial functioning. However improvement of psychosocial functioning seemed to be from a rather short-lived nature as it was not found to be significantly improved six months upon the completion of cognition training (follow-up). Nonetheless, the positive impact of CRT seem to help patients master their daily routines and face daily obstacles with improved social and psychological resources for a short period of time. These results point to the fact, that booster-sessions may be necessary after a frequent training in order to maintain effects on psychosocial function at the long term. Moreover, the attentional improvement was reliable and clinically significant and persisted for 6 months. No improvement differences between the individualized and generalized training groups were found. In conclusion we propose CRT as an integral part of the treatment plan for patients with depression who suffer from cognitive deficits. Unexpectedly, no improvement differences between the individualized and generalized training groups were found. This finding can be attributed to the high load of attention training in both individualized and generalized training, thus limiting the possibility of finding significant differences between them. All participants in both training groups trained at least one attentional subdomain due to the widespread attentional impairment in our sample shown at baseline assessment. However, this reflects the high prevalence of attentional impairment in remitted depression samples and a high relevance to target the attention domain. The improvement of psychosocial functioning seemed to be from a rather short-lived nature as it was not found to be significantly improved six months upon the completion of cognition training. These results point to the need of longer training periods or booster sessions. The acceptance of the provided cognitive training was even higher as expected. The drop-out rate was very low. Only five participants dropped out of the training, four of them due to the overlap with working schedules or new job / work reintegration. Only two participants dropped out at follow up measurement six months after the intervention.
Publications
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(2015). Kognitive Defizite bei Depressionen und ihre Behandlung. PSYCH up2date, 9(02), 101-112
Roesch-Ely, D., Weisbrod, M., & Bartolovic, M.
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(2018). Cognitive Impairment Along the Course of Depression: Non-Pharmacological Treatment Options. Psychopathology, 51(5), 295-305
Listunova, L., Roth, C., Bartolovic, M., Kienzle, J., Bach, C., Weisbrod, M., & Roesch-Ely, D.
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(2018). Neurocognitive performance in patients with depression compared to healthy controls: Association of clinical variables and remission state. Psychiatry Research
Grützner, T. M., Sharma, A., Listunova, L., Bartolovic, M., Weisbrod, M., & Roesch-Ely, D.
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(2018). Serum calcium levels and neuropsychological performance in depression and matched healthy controls: Reversal of correlation a marker of the aging cognitive clock? Psychoneuroendocrinology, 91, 198-205
Grützner, T. M., Listunova, L., Fabian, G. A., Kramer, B. A., Flach, D., Weisbrod, M. & Sharma, A.
