Randomized clinical trial of integral cognitive remediation program for major depression (INCREM)

Vicent-Gil, Muriel; González-Simarro, Sara; Raventós, Beatriz; Vera, Javier; Martínez, Eduardo D. Marín; Sabaté-Cao, Carlota; Pérez-Blanco, Josefina; Puigdemont, Dolors; Diego-Adeliño, Javier de; Alemany, Carlo; Serra-Blasco, M.; Cardoner, Narcı́s; Portella, María J.

doi:10.1016/j.jad.2022.05.016

Cited by 8 publications

(6 citation statements)

References 30 publications

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“…The elevated levels of rumination after the 6-month assessment might be related to the observed increase in symptoms of MDD. These findings are in contrast both with a previous study that reported long-term improvements in rumination and symptoms of MDD in adults with MDD receiving a strategy based intervention ( Hagen and Stubberud, 2021 ) and with a randomized controlled trial ( Vicent-Gil et al, 2022a ) and meta-analysis ( Legemaat et al, 2021 ) showing that cognitive enhancement interventions did not affect symptoms of MDD. Taken together, the mixed findings in the research literature illustrates the importance of further exploring the impact that cognitive enhancement interventions have on rumination and symptoms of MDD.…”

Section: Discussioncontrasting

confidence: 99%

“…Moreover, none of the above studies have separately tested specific intervention components, such as psychoeducation, drill-and-practice training, and strategies. However, a randomized controlled trial with a 6-month follow-up did find that functional and drill-and-practice training combined with psychoeducation yielded better functional outcomes than psychoeducation alone ( Vicent-Gil et al, 2022a ). Long-term follow-up studies should therefore further explore the efficacy of intervention components and mechanisms of change to refine cognitive enhancement interventions.…”

Section: Discussionmentioning

confidence: 99%

“…Research on interventions targeting cognitive deficits is often criticized for not investigating functional outcomes, which may be the most important and relevant outcome for the target group. Only a few studies targeted functional recovery specifically ( Listunova et al, 2020b ; Vicent-Gil et al, 2022a ), showing promising results. Future research should therefore further investigate measures of functional outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…However, there is less research on interventions aiming to improve cognition in individuals with a history of MDD. Short-term effects of cognitive enhancement interventions in formerly depressed adults show promising results in improving self-reported cognitive deficits, performance in neuropsychological tests, rumination, and daily life functioning ( Hoorelbeke and Koster, 2017 ; Listunova et al, 2020b ; Hammar et al, 2022 ; Myklebost et al, 2022c ; Vicent-Gil et al, 2022a ). A recent meta-analysis of cognitive enhancement interventions that included samples both in the acute state of MDD and in remission found improved short-term performance for neuropsychological tests, functioning in daily life, and symptoms of MDD ( Legemaat et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

“…There are several 6-month follow-up studies that have reported promising findings on cognitive enhancement interventions in MDD ( Myklebost et al, 2022c ; Vicent-Gil et al, 2022a ). However, to our knowledge, only one previous study has investigated the 1-year follow-up results of cognitive enhancement interventions for individuals partly in remission from MDD ( Hoorelbeke et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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Long-term outcomes of an internet-delivered cognitive enhancement intervention targeting residual cognitive deficits after major depressive disorder: a 2-year follow-up of an open trial

Myklebost,

Nordgreen,

Klakegg

et al. 2023

Front. Psychol.

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BackgroundCognitive deficits are common and disabling residual symptoms following major depressive disorder (MDD) and are related to increased risk of relapse. Residual cognitive deficits should thus be considered an important target for treatment. However, few have reported long-term outcomes of interventions targeting residual cognitive deficits.ObjectiveThis study aimed to (1) investigate change between pre-treatment and 2-year follow-up assessments in cognitive deficits, rumination, and symptoms of MDD after an internet-delivered intervention targeting residual cognitive deficits; (2) to investigate stability in outcomes between 6-month and 2-year follow-up assessments; (3) to report the number of participants’ experiencing a new episode of MDD in the follow-up period; and (4) to investigate differences in outcomes between those who experienced a new episode of MDD and those who did not.MethodsA total of 43 partly remitted adults were included to test a guided internet-delivered intervention, which consisted of 10 modules involving psychoeducation, cognitive strategies, and attention training. Participants were assessed at pre-treatment, post-treatment, after 6-months, and after 2-years, with measures assessing self-reported residual cognitive deficits, rumination, symptoms of MDD and relapse. Overall, 32 participants completed the 2-year follow-up assessment.ResultsBetween the pre-treatment and 2-year follow-up assessments, there was a reduction in cognitive deficits and rumination, while there was an increase in symptoms of MDD. Cognitive deficits were stable between the 6-month and the 2-year follow-up, while there was an increase in rumination and symptoms of MDD. Thirteen of 32 participants reported a new episode of MDD during the follow-up period. The relapse group reported longer duration of MDD at pre-treatment and showed a difference in all outcomes after 2 years compared to the no-relapse group. The no-relapse group showed improvement in MDD symptoms at post-treatment, while the relapse group did not.ConclusionDelivering cognitive enhancement interventions over the internet is potentially related to stable improvements in residual cognitive deficits. The effects on rumination and symptoms of MDD are less certain. Lack of improvement in MDD symptoms after the intervention period should be investigated as an indicator of relapse. Results should be interpreted with caution due to the lack of control group and sample size.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%