Psychological Medicine

Original Article

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

SAFA ELGAMALa1, MARGARET C. McKINNONa1, KARUNA RAMAKRISHNANa1, RUSSELL T. JOFFEa2 and GLENDA MacQUEENa1 c1

a1 McMaster University, Hamilton, Ontario, Canada

a2 University of Medicine and Dentistry New Jersey, Newark, NJ, USA

ABSTRACT

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.

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.

(Online publication July 05 2007)

Correspondence

c1 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, Canada L8N 3K7. (Email: macqueng@mcmaster.ca)

Footnotes

† These authors contributed equally to this work.

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