Abstract
Patients with unipolar depressive disorder and in the depressive phase of bipolar disorder often manifest psychological distress and cognitive deficits, notably in executive control. We used computerized cognitive training in an attempt to reduce psychological affliction, improve everyday coping, and cognitive function. We asked one group of patients (intervention group) to engage in cognitive training three times a week, for 20 min each time, for eight consecutive weeks. A second group of patients (control group) received standard care only. Before the onset of training we administered to all patients self-report questionnaires of mood, mental and psychological health, and everyday coping. We also assessed executive control using a broad computerized neurocognitive battery of tests which yielded, among others, scores in Working Memory, Shifting, Inhibition, Visuomotor Vigilance, Divided Attention, Memory Span, and a Global Executive Function score. All questionnaires and tests were re-administered to the patients who adhered to the study at the end of training. When we compared the groups (between-group comparisons) on the amount of change that had taken place from baseline to post-training, we found significantly reduced depression level for the intervention group. This group also displayed significant improvements in Shifting, Divided Attention, and in the Global executive control score. Further exploration of the data showed that the cognitive improvement did not predict the improvements in mood. Single-group data (within-group comparisons) show that patients in the intervention group were reporting fewer cognitive failures, fewer dysexecutive incidents, and less difficulty in everyday coping. This group had also improved significantly on the six executive control tests and on the Global executive control score. By contrast, the control group improved only on the reports of cognitive failure and on working memory.
Highlights
Marvel and Paradiso (2004) pinpoint three major categories of deficits as related to depressive disorders: attention, executive function, and memory
Cohen’s d, calculated for the self-report questionnaires, showed small-sized (CFQ; SOS-10), medium-sized (EMQ), and large-sized (BDI and Dysexecutive Questionnaire (DEX)) effects, all in favor of the cognitive training group. These results show that the cognitive training group, but not the control group, reported clinically significant improvement in levels of depression, in experienced cognitive failures, experienced executive failures, experienced memory failures, and higher levels of satisfaction and well-being
When compared to the control participants, participants in the cognitive training group reported significantly lower levels of depression on Beck’s BDI-II. To our knowledge this is the first study to report a reduction in depressive symptomatology, following cognitive training
Summary
Marvel and Paradiso (2004) pinpoint three major categories of deficits as related to depressive disorders: attention, executive function, and memory. The present study sought to examine the impact of cognitive training on self-reported everyday functioning, and on executive control and attention scores obtained using a multi-domain computerized neurocognitive battery of tasks in outpatients with unipolar and bipolar depression. This battery included tasks not measuring executive control
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