Abstract

Attentional deficits as well as attentional biases towards negative material are related to major depression and might maintain chronicity. However, studies investigating attentional deficits and attentional biases in chronic, treatment-resistant depressed are lacking. The aim of the current study was to compare measures of attentional deficits and attentional bias between chronic, treatment-resistant depressed outpatients and never-depressed control participants. Attentional deficits were assessed with the attentional control scale (ACS) and the Stroop Color naming task. Attentional bias was measured with the exogenous cueing task (ECT) and an emotional Stroop task. Chronic, treatment-resistant depressed patients (n = 80) showed significantly more attentional deficits than never-depressed controls (n = 113) on the ACS and Stroop color-naming task. However, in contrast with hypotheses, no differences were found between chronic, treatment-resistant depressed patients and never-depressed individuals on the ECT or emotional Stroop task. The current findings indicate that chronic, treatment-resistant depressed patients present attentional deficits. The results however question whether this patient group shows attentional biases for negative material. Future research should include comparisons of chronic, treatment-resistant and non-chronically depressed patients. If replicated, these current results might indicate that focusing on improving attentional deficits could be a more promising target for treatment than addressing attentional biases.

Highlights

  • Depressed patients not responding well to treatment are a major challenge for mental health care (Cuijpers et al, 2017)

  • We explored whether attentional deficits and/or attentional biases are correlated with chro­ nicity, treatment-resistance or severity of the current depressive episode

  • Further research is needed to investigate the exact role of attentional processes in chronic and treatment-resistant depression

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Summary

Introduction

Depressed patients not responding well to treatment are a major challenge for mental health care (Cuijpers et al, 2017). The prevalence of both chronic and treatment-resistant depression are high. Patients who do not respond to treatment often develop a chronic course (Berlim and Turecki, 2007) and chronically depressed patients often respond less well to treatment (Cuijpers et al, 2010). Investigating cognitive and psychological factors that charac­ terize patients with chronic, treatment-resistant depression (cTRD) is important to further understand depression and improve treatment. Impor­ tantly, only a minority of studies investigated maladaptive cognitive processes or psychological characteristics that could be implicated in cTRD. Knowledge about attentional characteristics of cTRD is surprisingly limited

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