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互联网认知增强干预对缓解期重度抑郁症患者主观残留认知缺陷的疗效:一项随机交叉试验。

Efficacy of an internet-delivered cognitive enhancement intervention for subjective residual cognitive deficits in remitted major depressive disorder: A randomized crossover trial.

机构信息

Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Norway.

Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.

出版信息

J Affect Disord. 2024 Nov 1;364:87-95. doi: 10.1016/j.jad.2024.08.035. Epub 2024 Aug 12.

Abstract

BACKGROUND

Cognitive deficits such as difficulties with attention, memory, and executive functions are frequently reported during remission from depression and relates to adverse functioning in daily life and risk of relapse. There is therefore a need for interventions targeting cognitive deficits after depression. However, few randomized controlled trials have investigated the efficacy of interventions targeting subjective residual cognitive deficits in adults remitted from depression.

METHODS

This randomized crossover trial aimed to investigate the efficacy of an internet-delivered cognitive enhancement intervention on subjective residual cognitive deficits. Forty-four formerly depressed adults (89 % female;mean age = 39 years) were included. Twenty-three participants received the intervention, and 21 participants were assigned to a waitlist control group. The waitlist control group received the intervention after seven weeks. Analyses of follow-up assessment after six months were conducted for the combined sample.

RESULTS

Significant differences were found between the intervention and waitlist control group in subjective cognitive functioning (d = 1.83) and rumination (d = 1.65). There was a difference in symptoms of depression between the groups (d = 1.22), whereas symptoms of depression increased in the waitlist control, but not in the intervention group. Fewer participants in the waitlist control group (43 %), compared to the intervention group (78 %) showed reliable improvement in self-reported cognitive deficits after receiving the intervention.

LIMITATIONS

Findings should be interpreted with caution due to the small sample, and lack of an active control group.

CONCLUSIONS

Internet-delivered cognitive enhancement interventions may improve subjective cognitive deficits. Waiting time to receive cognitive enhancement interventions may worsen symptoms and treatment response.

摘要

背景

抑郁缓解期常出现注意力、记忆和执行功能等认知缺陷,与日常生活功能不良和复发风险相关。因此,需要针对抑郁缓解后的认知缺陷进行干预。然而,很少有随机对照试验研究针对成人抑郁缓解后主观残留认知缺陷的干预措施的疗效。

方法

本随机交叉试验旨在研究基于互联网的认知增强干预对主观残留认知缺陷的疗效。共纳入 44 名曾抑郁的成年人(89%为女性;平均年龄 39 岁)。23 名参与者接受了干预,21 名参与者被分配到等待名单对照组。等待名单对照组在七周后接受干预。对六个月后的随访评估进行了综合样本分析。

结果

干预组和等待名单对照组在主观认知功能(d=1.83)和反刍(d=1.65)方面存在显著差异。两组之间存在抑郁症状的差异(d=1.22),而等待名单对照组的抑郁症状增加,而干预组则没有。与等待名单对照组(43%)相比,接受干预后,等待名单对照组中(78%)有更多的参与者表现出可靠的自我报告认知缺陷改善。

局限性

由于样本量小且缺乏主动对照组,因此应谨慎解释研究结果。

结论

基于互联网的认知增强干预可能改善主观认知缺陷。等待接受认知增强干预的时间可能会使症状和治疗反应恶化。

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