Hagen Bjørn Ingulfsvann, Stubberud Jan
Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway.
Department of Psychology, University of Oslo, Oslo, Norway.
Front Psychiatry. 2021 Sep 24;12:737518. doi: 10.3389/fpsyt.2021.737518. eCollection 2021.
Information on the long-term effects of cognitive remediation (CR) in major depressive disorder (MDD) is lacking. The present study reports 2-year follow-up data from a previously published randomized controlled trial (RCT) from our research group, comparing Goal Management Training (GMT), a strategy-based CR intervention, to drill-and-practice computerized cognitive training (CCT). In previous work, we found comparable improvements in executive function (EF), in addition to reductions in depressive symptoms, following both GMT and CCT at 6-month follow-up. Forty-two participants of the RCT, all diagnosed with MDD, were invited to complete rating-scales pertaining daily-life EF, rumination, and depressive symptoms. Explorative analyses compared the 2-year follow-up with previously published baseline and 6-month follow-up data, using non-parametric statistics. Similarly, GMT and CCT were compared at the 2-year follow-up, and completers were compared with non-completers. Twenty participants completed the study. Overall, completers ( = 20) and non-completers ( = 22) were similar. There were no significant differences between GMT ( = 11) and CCT ( = 9) for any outcome 2 years post-treatment. Reduction compared to baseline in depressive symptoms and rumination, but not in daily-life EFs, emerged for GMT only. Findings suggest long-term improvements in mental health following GMT, while improvements in everyday EFs might require additional treatment or maintenance to sustain. Caution is warranted in the interpretation due to the small sample size and high attrition rates.
目前尚缺乏关于认知康复（CR）对重度抑郁症（MDD）长期影响的信息。本研究报告了我们研究小组之前发表的一项随机对照试验（RCT）的2年随访数据，该试验将基于策略的CR干预措施目标管理训练（GMT）与计算机化认知训练（CCT）的反复练习进行了比较。在之前的研究中，我们发现在6个月的随访中，GMT和CCT在改善执行功能（EF）以及减轻抑郁症状方面效果相当。该RCT的42名参与者均被诊断为MDD，他们被邀请完成与日常生活EF、沉思和抑郁症状相关的评分量表。探索性分析使用非参数统计方法，将2年随访数据与之前发表的基线数据和6个月随访数据进行了比较。同样，在2年随访时对GMT和CCT进行了比较，并将完成者与未完成者进行了比较。20名参与者完成了研究。总体而言，完成者（n = 20）和未完成者（n = 22）相似。治疗2年后，GMT组（n = 11）和CCT组（n = 9）在任何结果上均无显著差异。仅GMT组的抑郁症状和沉思与基线相比有所减轻，但日常生活EF没有变化。研究结果表明，GMT治疗后心理健康有长期改善，而日常EF的改善可能需要额外的治疗或维持措施来维持。由于样本量小和失访率高，在解释结果时应谨慎。
