J Psychiatr Pract. 2020 Jul;26(4):273-283. doi: 10.1097/PRA.0000000000000487.
Current first-line treatments for mood disorders often improve mood symptoms but do little to reduce cognitive and functional impairment. This 10-week, uncontrolled, feasibility study evaluated a cognitive remediation (CR) intervention for individuals with recurrent mood disorders. Adults with recurrent major depressive disorder or bipolar disorder, who had recently been treated and discharged from specialized mental health services, were eligible for inclusion. Twenty patients completed the CR intervention, which involved weekly individual sessions with a therapist, as well as the practice of computerized CR exercises between sessions. The study assessed the acceptability of the assessment and treatment as well as outcomes in terms of mood symptoms, general functioning, and cognitive functioning. Patients reported that they were generally satisfied with the CR intervention and were close to reaching the recommended amount of practice between therapist-led sessions. The retention rate from baseline to posttreatment was 87%. When within-group effects were examined, large effect sizes over time (>0.9) were seen for 2 cognitive variables that measured executive function: Category Switching-Total Words and Total Switching Score. Findings from the current feasibility study will inform the development of a large randomized controlled trial of an adapted version of the CR intervention for mood disorders assessed in this preliminary study, with the goal of translating the intervention into clinical practice.
目前用于治疗心境障碍的一线治疗方法通常可以改善情绪症状，但对认知和功能损害的改善作用不大。这项为期 10 周的非对照可行性研究评估了一种针对复发性心境障碍患者的认知矫正（CR）干预措施。符合纳入标准的是最近在专门的精神卫生服务机构接受治疗并出院的复发性重度抑郁症或双相情感障碍成年人。20 名患者完成了 CR 干预，包括每周与治疗师进行一次个体治疗，以及在治疗期间进行计算机化的 CR 练习。该研究评估了评估和治疗的可接受性以及情绪症状、一般功能和认知功能方面的结果。患者报告说，他们对 CR 干预通常感到满意，并且接近达到治疗师指导的治疗期间推荐的练习量。从基线到治疗后的保留率为 87%。当检查组内效应时，2 项测量执行功能的认知变量随时间的变化均显示出较大的效应量（>0.9）：类别转换-总词数和总转换分数。本初步研究评估了一种适应版的 CR 干预用于心境障碍的大型随机对照试验，该可行性研究的结果将为其开发提供信息，目标是将干预措施转化为临床实践。
