Semkovska Maria, Ahern Elayne
Department of Psychology, University of Limerick, Limerick, Ireland.
Internet Interv. 2017 Apr 29;9:7-14. doi: 10.1016/j.invent.2017.04.003. eCollection 2017 Sep.
Major depression is a highly prevalent psychopathology with high relapse rates. Following remission from a depressive episode, neurocognitive difficulties in attention, working memory and executive function often persist, preventing full clinical recovery. These neurocognitive deficits are often present since the first depressive episode and have been shown to predict relapse. The efficacy of computerised neurocognitive remediation therapy (NCRT) to improve attention, memory and executive function has been demonstrated in several clinical populations but randomised controlled trials (RCT) have not been conducted in depression. The present study aimed to conduct a pilot, randomised study, of computerised NCRT for individuals with past depression, currently in remission. Twenty two individuals remitted from depression were randomly assigned to receive 20 one-hour sessions over 5 week of ether computerised NCRT or a component-equivalent allocation (play online computer games). The NCRT group showed significantly larger improvements in performance relative to the Games group in the three targeted neurocognitive domains: divided attention, verbal working memory, and planning, but also in non-targeted domains of long-term verbal memory and switching abilities. No significant effect was observed in the NCRT-targeted domain visual working memory. These preliminary results suggest computerised NCRT efficacy to improve targeted neurocognitive processes during depression remission and support its potential value as preventative connected intervention tool.
重度抑郁症是一种高发性精神病理学疾病，复发率很高。在抑郁发作缓解后，注意力、工作记忆和执行功能方面的神经认知困难往往持续存在，阻碍了临床的完全康复。这些神经认知缺陷自首次抑郁发作起就常常存在，并已被证明可预测复发。计算机化神经认知康复治疗（NCRT）改善注意力、记忆和执行功能的疗效已在多个临床群体中得到证实，但尚未在抑郁症患者中进行随机对照试验（RCT）。本研究旨在针对既往有抑郁症且目前已缓解的个体开展一项计算机化NCRT的试点随机研究。22名抑郁症缓解期患者被随机分配，在5周内接受20次为时1小时的计算机化NCRT治疗或等效的对照治疗（玩在线电脑游戏）。与游戏组相比，NCRT组在三个目标神经认知领域（分散注意力、言语工作记忆和计划）以及长期言语记忆和转换能力等非目标领域的表现有显著更大的改善。在NCRT目标领域视觉工作记忆方面未观察到显著效果。这些初步结果表明，计算机化NCRT在改善抑郁症缓解期的目标神经认知过程方面具有疗效，并支持其作为预防性关联干预工具的潜在价值。
