Cognitive training for neurocognitive and functional impairments in obsessive compulsive disorder: A case report

Abstract

Obsessive-compulsive disorder (OCD) is associated with impairments in neurocognition, especially on executive functioning and visuospatial memory, which tend to persist despite clinical improvement. Impairments in social and occupational functioning are likely related to neurocognition but are rarely targeted by existing treatments for OCD. Previous studies of cognitive training in OCD have been limited by narrow transfer of effects. We report a case of an individual referred for cognitive training in view of persisting cognitive and functional difficulties despite clinical improvement. The intervention consisted of therapist-guided sessions along with homework practice. A smartphone application was developed for cognitive stimulation, and used with other techniques for cognitive stimulation, strategy use, and generalization to achieve transfer of effects. Following 12 weeks of intervention, changes were observed on executive functions including verbal fluency and planning, and smaller changes across measures of attention and working memory. Notably, there was simultaneous reduction on severity of anxiety, depression, and obsessive-compulsive symptoms. Further, there was improvement in subjectively perceived cognitive difficulties as well as work, family and social functioning. The cognitive training intervention has promising implications for individuals with OCD with persisting cognitive and functional impairments despite clinical improvement.