Abstract
Objective: 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.Methods: 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.Results: Twenty participants completed the study. Overall, completers (n = 20) and non-completers (n = 22) were similar. There were no significant differences between GMT (n = 11) and CCT (n = 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.Conclusions: 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.
Highlights
Major depressive disorder (MDD) is a prevalent and debilitating condition that often includes a cyclic course of remission and relapse [1]
The present study report 2-year follow-up data from a randomized controlled trial (RCT) (n = 63) comparing a strategy-based Cognitive remediation (CR) intervention for improving executive functions (EFs), Goal Management Training–GMT [12], with drill-and-practice computerized cognitive training (CCT), in a depression sample
In contrast to the recent meta-analysis by Legemaat et al [7], the present study identified long-term improvements in depressive symptoms, in addition to reduced rumination, following CR
Summary
Major depressive disorder (MDD) is a prevalent and debilitating condition that often includes a cyclic course of remission and relapse [1]. Deficits in cognitive functions, including executive functions (EFs), are common in MDD, and frequently remain following the alleviation of affective symptoms [2, 3]. These deficits, executive dysfunction, negatively impact daily-life. Drill-and-practice approaches involve exercises to improve cognitive functions, while strategy-based CR aim to promote the application of compensatory strategies in daily life [7]. A recent meta-analysis including both drill-and-practice- and strategy-based approaches found a moderate effect of CR on cognitive functioning, including EFs, and small effects on depressive symptoms and daily functioning, when compared to non-CR control conditions [7]. Comparisons of long-term outcomes following drill-and-practice- and strategy-based approaches are lacking
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