Cognitive rehabilitation for improving cognitive functions and reducing the severity of depressive symptoms in adult patients with Major Depressive Disorder: a systematic review and meta-analysis of randomized controlled clinical trials
Abstract Introduction Nearly 40% of patients with Major Depressive Disorder (MDD) have been found to experience cognitive impairment in at least one domain. Cognitive impairment associated with MDD is disproportionately represented in patients that have not fully returned to psychosocial functioning...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-01-01
|
| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12888-023-04554-w |
| _version_ | 1811175737865011200 |
|---|---|
| author | Saba Mokhtari Asieh Mokhtari Farah Bakizadeh Alireza Moradi Mohammadreza Shalbafan |
| author_facet | Saba Mokhtari Asieh Mokhtari Farah Bakizadeh Alireza Moradi Mohammadreza Shalbafan |
| author_sort | Saba Mokhtari |
| collection | DOAJ |
| description | Abstract Introduction Nearly 40% of patients with Major Depressive Disorder (MDD) have been found to experience cognitive impairment in at least one domain. Cognitive impairment associated with MDD is disproportionately represented in patients that have not fully returned to psychosocial functioning. As awareness regarding cognitive dysfunction in MDD patients grows, so does the interest in developing newer treatments that specifically address these deficits. Method In the present study, we conduct a systematic review of controlled randomized clinical trials that used cognitive training and remediation interventions for improving cognitive functions and reducing symptom severity in adult patients with MDD. We selected studies published before March 2022 using search databases including PubMed, ScienceDirect, Scopus, and Google scholar. For conducting the meta-analysis, standard differences in means with the random effect model and with a 95% confidence interval of change in outcome measures from baseline to post-intervention between the cognitive rehabilitation and the control groups were calculated. Results The database search resulted in identifying 756 studies of interest, which ultimately 15 studies with 410 participants in the cognitive rehabilitation group and 339 participants in the control group were included. The meta-analysis of the data extracted from these studies, shows a moderate and significant effect on the executive function (d = 0.59 (95% CI, 0.25 to 0.93) p-value = 0.001, I2 = 15.2%), verbal learning (d = 0.45 (95% CI, 0.12 to 0.78) p-value = 0.007, I2 = 0.00%), and working memory (d = 0.41 (95% CI, 0.18 to 0.64) p-value < 0.001, I2 = 33%) of MDD patients. Although, there were no significant difference between intervention and control group in attention (d = 0.32 (95% CI, -0.01 to 0.66) p-value = 0.058, I2 = 0.00%) or depressive symptoms. Conclusion This systematic review and meta-analysis indicate that cognitive rehabilitation is an effective intervention for the executive function, verbal learning, and working memory of MDD patients. Due to the importance of these neuropsychological deficits in day-to-day life and the core symptoms of MDD, cognitive rehabilitation should be considered an important part of treating MDD. Further research in this area and concentrated on these particular deficits is warranted. |
| first_indexed | 2024-04-10T19:40:42Z |
| format | Article |
| id | doaj.art-3c07b1736fb145919b733fb6e0fb16a1 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-04-10T19:40:42Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-3c07b1736fb145919b733fb6e0fb16a12023-01-29T12:18:44ZengBMCBMC Psychiatry1471-244X2023-01-0123111810.1186/s12888-023-04554-wCognitive rehabilitation for improving cognitive functions and reducing the severity of depressive symptoms in adult patients with Major Depressive Disorder: a systematic review and meta-analysis of randomized controlled clinical trialsSaba Mokhtari0Asieh Mokhtari1Farah Bakizadeh2Alireza Moradi3Mohammadreza Shalbafan4Department of Psychiatry, University of Social Welfare and Rehabilitation SciencesSchool of Allied Medical Sciences, Iran University of Medical SciencesDepartment of Psychology, University of TehranDepartment of Clinical Psychology, Kharrazmi UniversityMental Health Research Center, Psychosocial Health Research Institute (PHRI), Department of Psychiatry, School of Medicine, Iran University of Medical SciencesAbstract Introduction Nearly 40% of patients with Major Depressive Disorder (MDD) have been found to experience cognitive impairment in at least one domain. Cognitive impairment associated with MDD is disproportionately represented in patients that have not fully returned to psychosocial functioning. As awareness regarding cognitive dysfunction in MDD patients grows, so does the interest in developing newer treatments that specifically address these deficits. Method In the present study, we conduct a systematic review of controlled randomized clinical trials that used cognitive training and remediation interventions for improving cognitive functions and reducing symptom severity in adult patients with MDD. We selected studies published before March 2022 using search databases including PubMed, ScienceDirect, Scopus, and Google scholar. For conducting the meta-analysis, standard differences in means with the random effect model and with a 95% confidence interval of change in outcome measures from baseline to post-intervention between the cognitive rehabilitation and the control groups were calculated. Results The database search resulted in identifying 756 studies of interest, which ultimately 15 studies with 410 participants in the cognitive rehabilitation group and 339 participants in the control group were included. The meta-analysis of the data extracted from these studies, shows a moderate and significant effect on the executive function (d = 0.59 (95% CI, 0.25 to 0.93) p-value = 0.001, I2 = 15.2%), verbal learning (d = 0.45 (95% CI, 0.12 to 0.78) p-value = 0.007, I2 = 0.00%), and working memory (d = 0.41 (95% CI, 0.18 to 0.64) p-value < 0.001, I2 = 33%) of MDD patients. Although, there were no significant difference between intervention and control group in attention (d = 0.32 (95% CI, -0.01 to 0.66) p-value = 0.058, I2 = 0.00%) or depressive symptoms. Conclusion This systematic review and meta-analysis indicate that cognitive rehabilitation is an effective intervention for the executive function, verbal learning, and working memory of MDD patients. Due to the importance of these neuropsychological deficits in day-to-day life and the core symptoms of MDD, cognitive rehabilitation should be considered an important part of treating MDD. Further research in this area and concentrated on these particular deficits is warranted.https://doi.org/10.1186/s12888-023-04554-wCognitive FunctionMajor Depressive DisorderSystematic ReviewMeta-AnalysisExecutive functionVerbal learning |
| spellingShingle | Saba Mokhtari Asieh Mokhtari Farah Bakizadeh Alireza Moradi Mohammadreza Shalbafan Cognitive rehabilitation for improving cognitive functions and reducing the severity of depressive symptoms in adult patients with Major Depressive Disorder: a systematic review and meta-analysis of randomized controlled clinical trials BMC Psychiatry Cognitive Function Major Depressive Disorder Systematic Review Meta-Analysis Executive function Verbal learning |
| title | Cognitive rehabilitation for improving cognitive functions and reducing the severity of depressive symptoms in adult patients with Major Depressive Disorder: a systematic review and meta-analysis of randomized controlled clinical trials |
| title_full | Cognitive rehabilitation for improving cognitive functions and reducing the severity of depressive symptoms in adult patients with Major Depressive Disorder: a systematic review and meta-analysis of randomized controlled clinical trials |
| title_fullStr | Cognitive rehabilitation for improving cognitive functions and reducing the severity of depressive symptoms in adult patients with Major Depressive Disorder: a systematic review and meta-analysis of randomized controlled clinical trials |
| title_full_unstemmed | Cognitive rehabilitation for improving cognitive functions and reducing the severity of depressive symptoms in adult patients with Major Depressive Disorder: a systematic review and meta-analysis of randomized controlled clinical trials |
| title_short | Cognitive rehabilitation for improving cognitive functions and reducing the severity of depressive symptoms in adult patients with Major Depressive Disorder: a systematic review and meta-analysis of randomized controlled clinical trials |
| title_sort | cognitive rehabilitation for improving cognitive functions and reducing the severity of depressive symptoms in adult patients with major depressive disorder a systematic review and meta analysis of randomized controlled clinical trials |
| topic | Cognitive Function Major Depressive Disorder Systematic Review Meta-Analysis Executive function Verbal learning |
| url | https://doi.org/10.1186/s12888-023-04554-w |
| work_keys_str_mv | AT sabamokhtari cognitiverehabilitationforimprovingcognitivefunctionsandreducingtheseverityofdepressivesymptomsinadultpatientswithmajordepressivedisorderasystematicreviewandmetaanalysisofrandomizedcontrolledclinicaltrials AT asiehmokhtari cognitiverehabilitationforimprovingcognitivefunctionsandreducingtheseverityofdepressivesymptomsinadultpatientswithmajordepressivedisorderasystematicreviewandmetaanalysisofrandomizedcontrolledclinicaltrials AT farahbakizadeh cognitiverehabilitationforimprovingcognitivefunctionsandreducingtheseverityofdepressivesymptomsinadultpatientswithmajordepressivedisorderasystematicreviewandmetaanalysisofrandomizedcontrolledclinicaltrials AT alirezamoradi cognitiverehabilitationforimprovingcognitivefunctionsandreducingtheseverityofdepressivesymptomsinadultpatientswithmajordepressivedisorderasystematicreviewandmetaanalysisofrandomizedcontrolledclinicaltrials AT mohammadrezashalbafan cognitiverehabilitationforimprovingcognitivefunctionsandreducingtheseverityofdepressivesymptomsinadultpatientswithmajordepressivedisorderasystematicreviewandmetaanalysisofrandomizedcontrolledclinicaltrials |