Hammar Åsa, Semkovska Maria, Borgen Ida M H, Myklebost Sunniva, Ronold Eivind H, Sveen Thea, Ueland Torill, Porter Richard, Johnson Sheri L
Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.
Division of Psychiatry, Haukeland University Hospital, University of Bergen, Bergen, Norway.
Appl Neuropsychol Adult. 2022 Mar-Apr;29(2):172-182. doi: 10.1080/23279095.2020.1726919. Epub 2020 Feb 23.
Major depressive disorder (MDD) is associated with working memory (WM) impairments. These deficits often persist following remission and are associated with rumination, a recognized risk factor for depression relapse. The efficacy of WM-targeted cognitive remediation as a potential relapse prevention tool has not been investigated. The present pilot study aimed to investigate the feasibility, acceptability, and cognitive benefits of a WM-targeted cognitive remediation program in remitted depression. Twenty-eight MDD participants in remission were recruited. The intervention consisted of twenty-five 30-40-minute training sessions, coupled with weekly coaching, administered over a 5-week period. Before and after the intervention, a battery of objective neuropsychological tests and self-report measures was administered. Key outcomes were WM, inhibition and rumination. Acceptability of the intervention was observed, with 83% showing high motivation, along with WM gains for all completers ( 18, 64% of recruited participants). The cognitive remediation selectively improved targeted WM functions, as measured by objective tests. This did not translate into self-reported improvements in everyday WM or inhibition. However, all but one completer achieved at least one personal goal related to WM and 44% achieved two or, the maximum possible, three such goals. For remitters whose WM was significantly enhanced after the intervention, the cognitive remediation also decreased dysphoric-mood related rumination. The successful pilot testing of the WM-targeted intervention supports the conduct of a fully powered randomized controlled trial as a relapse prevention approach in remitted MDD.
重度抑郁症（MDD）与工作记忆（WM）损害有关。这些缺陷在缓解后往往持续存在，并与沉思有关，沉思是抑郁症复发的一个公认风险因素。针对工作记忆的认知康复作为一种潜在的预防复发工具的疗效尚未得到研究。本试点研究旨在调查针对工作记忆的认知康复计划在缓解期抑郁症中的可行性、可接受性和认知益处。招募了28名处于缓解期的MDD参与者。干预包括25次30 - 40分钟的训练课程，并辅以每周一次的辅导，为期5周。在干预前后，进行了一系列客观神经心理学测试和自我报告测量。关键结果是工作记忆、抑制和沉思。观察到干预的可接受性，83%的人表现出高动机，所有完成者（18人，占招募参与者的64%）的工作记忆都有所提高。通过客观测试测量，认知康复选择性地改善了目标工作记忆功能。这并没有转化为日常工作记忆或抑制方面自我报告的改善。然而，除一名完成者外，所有完成者都至少实现了一个与工作记忆相关的个人目标，44%的人实现了两个或最多三个这样的目标。对于干预后工作记忆显著增强的缓解者，认知康复也减少了与烦躁情绪相关的沉思。针对工作记忆的干预的成功试点测试支持开展一项充分有力的随机对照试验，作为缓解期MDD的一种预防复发方法。
