Neuropsychological deficits in depression – a challenge for cognitive-behavioral therapies

Bartosz Piasecki; Karolina Kabzińska

doi:10.20883/medical.318

Authors

Bartosz Piasecki Department of Clinical Psychology, Poznan University of Medical Sciences, Poland https://orcid.org/0000-0002-2567-682X
Karolina Kabzińska Department of Clinical Psychology, Poznan University of Medical Sciences, Poland https://orcid.org/0000-0001-5515-8954

DOI:

https://doi.org/10.20883/medical.318

Keywords:

depression, neuropsychological deficits, cognitive-behavioral therapy

Abstract

Neuropsychological deficits in depression are a significant therapeutic challenge. Their occurrence means poor therapeutic prospects, worse social and professional functioning after therapy, as well as a higher risk of relapse. Despite clinical improvement, they often remain even in a state of complete remission. Beck’s model of depression does not include interventions directed at neuropsychological processes leading to neurocognitive mechanisms responsible for the development and maintenance of depression. More recent trends in cognitive-behavioral therapy seem to involve neuropsychological processes to a greater extent. This applies to Well’s metacognitive model, which focuses on the meta-level of thinking. Therapeutic process involves various aspects of attention, as well as detached mindfulness. Available empirical studies indicate that this therapy model is more effective in reducing neuropsychological deficits than Beck’s model. Acceptance and commitment therapy as well as mindfulness-based cognitivetherapy both focus on the development of skills that are related to the efficiency of executive functions and flexibility of attention, i.e. the cognitive processes whose deficits are characteristic of depression. However, research is needed to confirm their effectiveness in reducing neuropsychological deficiencies compared to other therapeutic models. Interventions in the field of cognitive remediationcan be used to enrich cognitive-behavioral therapies and increase their effectiveness. Until now, they have been used as a separate form of therapy, for example in anorexia.

Downloads

Download data is not yet available.

References

Spijker J, Graaf R, Bijl RV, Beekman ATF, Ormel J, Nolen WA. Functional disability and depression in the general population. Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Acta Psychiatr Scand 2004;110:208–14. doi:10.1111/j.1600-0447.2004.00335.x.

WHO. Depression and Other Common Mental Disorders. Global Health Estimates 2017.

WHO. The ICD-10 Classification of Mental and Behavioural Disorders. 2009.

Bortolato B, Carvalho AF, McIntyre RS. Cognitive dysfunction in major depressive disorder: a state-of-the-art clinical review. CNS Neurol Disord Drug Targets 2014;13:1804–18.

Porter RJ, Bowie CR, Jordan J, Malhi GS. Cognitive remediation as a treatment for major depression: A rationale, review of evidence and recommendations for future research. Aust N Z J Psychiatry 2013;47:1165–75. doi:10.1177/0004867413502090.

Semkovska M, Quinlivan L, O’Grady T, Johnson R, Collins A, O’Connor J, et al. Cognitive function following a major depressive episode: a systematic review and meta-analysis. Lancet Psychiatry 2019;6:851–61. doi:10.1016/S2215-0366(19)30291-3.

Hasselbalch BJ, Knorr U, Kessing LV. Cognitive impairment in the remitted state of unipolar depressive disorder: a systematic review. J Affect Disord 2011;134:20–31. doi:10.1016/j.jad.2010.11.011.

Rock PL, Roiser JP, Riedel WJ, Blackwell AD. Cognitive impairment in depression: a systematic review and meta-analysis. Psychol Med 2014;44:2029–40. doi:10.1017/S0033291713002535.

Groves SJ, Porter RJ, Jordan J, Knight R, Carter JD, McIntosh VVW, et al. Changes in neuropsychological function after treatment with metacognitive therapy or cognitive behaviour therapy for depression. Depress Anxiety 2015;32:437–44.

Lahr D, Beblo T, Hartje W. Cognitive performance and subjective complaints before and after remission of major depression. Cognit Neuropsychiatry 2007;12:25–45. doi:10.1080/13546800600714791.

Rohling ML, Green P, Allen LM 3rd, Iverson GL. Depressive symptoms and neurocognitive test scores in patients passing symptom validity tests. Arch Clin Neuropsychol Off J Natl Acad Neuropsychol 2002;17:205–22.

Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive therapy of depression. New York: Guilford Press; 1979.

Beck JS. Cognitive-behavior therapy. New York: Guilford Press; 2011.

Fennell M, Bennett-Levy J, Westbrook D. Depresja. Oksfordzki Podręcznik Eksp. Behawioralnych W Ter. Poznawczej, Gdynia: Alliance Press; 2004.

Popiel A, Pragłowska E. Psychoterapia poznawczo-behawioralna. Warszawa: Wydawnictwo Paradygmat.; 2008.

Beck AT, Bredemeier K. A Unified Model of Depression Integrating Clinical, Cognitive, Biological, and Evolutionary Perspectives. Clin Psychol Sci 2016;4:596–619.

Dobson KS. Cognitive Therapy for Depression. Cogn. Ther. Depress. Manag. Complex. Comorbidity, New York: Guilford Press; 2008, p. 3–33.

Driessen E, Hollon SD. Cognitive behavioral therapy for mood disorders: efficacy, moderators and mediators. Psychiatr Clin North Am 2010;33:537–55. doi:10.1016/j.psc.2010.04.005.

Hofmann SG, Asnaani A, Vonk IJJ, Sawyer AT, Fang A. The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cogn Ther Res 2012;36:427–40. doi:10.1007/s10608-012-9476-1.

Bora E, Harrison BJ, Yucel M, Pantelis C. Cognitive impairment in euthymic major depressive disorder: a meta-analysis. Psychol Med 2013;43:2017–26. doi:10.1017/S0033291712002085.

Wells A. Metacognitive therapy for anxiety and depression. New York: Guilford Press; 2009.

Pąchalska M. Rehabilitacja Neuropsychologiczna. Lublin: Wydawnictwo Uniwersytetu Marii Curie-Skłodowskiej; 2008.

Pąchalska M. Neuropsychologia kliniczna. vol. 1. Warszawa: Wydawnictwo Naukowe PWN; 2007.

Dammen T, Papageorgiou C, Wells A. An open trial of group metacognitive therapy for depression in Norway. Nord J Psychiatry 2015;69:126–31. doi:10.3109/08039488.2014.936502.

Jordan J, Carter JD, McIntosh VVW, Fernando K, Frampton CMA, Porter RJ, et al. Metacognitive therapy versus cognitive behavioural therapy for depression: a randomized pilot study. Aust N Z J Psychiatry 2014;48:932–43. doi:10.1177/0004867414533015.

Siegle GJ, Ghinassi F, Thase ME. Neurobehavioral Therapies in the 21st Century: Summary of an Emerging Field and an Extended Example of Cognitive Control Training for Depression. Cogn Ther Res 2007;31:235–262.

Tchanturia K, Giombini L, Leppanen J, Kinnaird E. Evidence for Cognitive Remediation Therapy in Young People with Anorexia Nervosa: Systematic Review and Meta-analysis of the Literature. Eur Eat Disord Rev J Eat Disord Assoc 2017;25:227–36. doi:10.1002/erv.2522.

Kabat-Zinn J. Życie, piękna katastrofa. Warszawa: Wydawnictwo Czarna Owca; 2013.

Segal ZV, Williams MG, Teasdale JD. Mindfulness-Based Cognitive Therapy for Depression. New York: Guilford Press; 2013.

Teasdale JD, Williams M, Segal Z. Praktyka uważności. Ośmiotygodniowy program ćwiczeń pozwalający uwolnić się od depresji i napięcia emocjonalnego. Kraków: WUJ; 2016.

Harris R. Zrozumieć ACT. Terapia akceptacji i zaangażowania w praktyce. Sopot: GWP; 2018.

Hayes SC, Strosahl KD, Wilson KG. Acceptance and Commitment Therapy An Experiential Approach to Behavior Change. New York: Guilford Press; 2003.

Chiesa A, Calati R, Serretti A. Does mindfulness training improve cognitive abilities? A systematic review of neuropsychological findings. Clin Psychol Rev 2011;31:449–64. doi:10.1016/j.cpr.2010.11.003.

McGurk SR, Twamley EW, Sitzer DI, McHugo GJ, Mueser KT. A meta-analysis of cognitive remediation in schizophrenia. Am J Psychiatry 2007;164:1791–802. doi:10.1176/appi.ajp.2007.07060906.

Bowie CR, Gupta M, Holshausen K, Jokic R, Best M, Milev R. Cognitive remediation for treatment-resistant depression: effects on cognition and functioning and the role of online homework. J Nerv Ment Dis 2013;201:680–5. doi:10.1097/NMD.0b013e31829c5030.

Leppanen J, Adamson J, Tchanturia K. Impact of Cognitive Remediation Therapy on Neurocognitive Processing in Anorexia Nervosa. Front Psychiatry 2018;9:96. doi:10.3389/fpsyt.2018.00096.

Priyamvada R, Ranjan R, Chaudhury S. Cognitive rehabilitation of attention and memory in depression. Ind Psychiatry J 2015;24:48–53. doi:10.4103/0972-6748.160932.

Woo YS, Rosenblat JD, Kakar R, Bahk W-M, McIntyre RS. Cognitive Deficits as a Mediator of Poor Occupational Function in Remitted Major Depressive Disorder Patients. Clin Psychopharmacol Neurosci Off Sci J Korean Coll Neuropsychopharmacol 2016;14:1–16. doi:10.9758/cpn.2016.14.1.1.