Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University, Voßstraße 4, 69115 Heidelberg, Germany.
Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University, Voßstraße 4, 69115 Heidelberg, Germany.
J Affect Disord. 2020 Mar 1;264:40-49. doi: 10.1016/j.jad.2019.12.006. Epub 2019 Dec 5.
There is urgent need for development and evaluation of targeted interventions for cognitive deficits in (partially) remitted major depression. Until now the analyses of the moderators of treatment efficacy were only examined in mixed samples of patients with schizophrenia, affective spectrum and schizoaffective disorders. Thus, the aim of our study was to evaluate the predictors of cognitive remediation therapy (CRT) improvement in a sample of (partially) remitted major depressive disorder patients.
Reliable Change Index with corrections for practice effects was calculated for each participant as an indicator for training improvement. Thirty eight patients, who were randomized within our previously conducted CRT clinical trial, were divided into "Improvers" and "Nonimprovers" in the attention domain, to compare them on sociodemographic, psychopathological, neurocognitive, psychosocial and training factors.
We detected 13 training participants who improved reliably in the attention domain. Illness duration was the only factor which significantly differentiated between Improvers and Nonimprovers. No significant differences between Improvers and Nonimprovers in terms of other clinical variables, sociodemographic and neuropsychological factors were found.
Exploratory research results should be taken with caution. Focus on the attention domain could have led to a limited point of view.
Our findings represent a first analysis of the predictors of cognitive remediation training improvement in (partially) remitted unipolar depression. Much more work should be done to refine cognitive treatment approaches. An initiation of cognitive training in early stages of the disease could be beneficial for the affected patients.
目前迫切需要开发和评估针对（部分）缓解的重度抑郁症认知缺陷的靶向干预措施。到目前为止，治疗效果的调节因素分析仅在精神分裂症、情感谱和分裂情感障碍的混合患者样本中进行了检查。因此，我们的研究目的是评估认知矫正治疗（CRT）在部分缓解的重度抑郁症患者样本中的预测因子。
为每个参与者计算了可靠变化指数（RCIs），并对练习效果进行了校正，作为培训改进的指标。38 名在我们之前进行的 CRT 临床试验中随机分组的患者，根据注意力域中的“改进者”和“非改进者”进行了划分，以比较他们的社会人口统计学、精神病理学、神经认知、心理社会和培训因素。
我们检测到 13 名在注意力域中可靠提高的培训参与者。疾病持续时间是区分改进者和非改进者的唯一因素。在其他临床变量、社会人口统计学和神经心理学因素方面，改进者和非改进者之间没有显著差异。
探索性研究结果应谨慎对待。关注注意力域可能会导致观点有限。
我们的研究结果代表了对（部分）缓解的单相抑郁症认知矫正训练改善预测因子的首次分析。为了完善认知治疗方法，还需要做更多的工作。在疾病早期开始认知训练可能对受影响的患者有益。
