Page last updated on Oct 31,2017
Depression is a very common medical condition that effects a large number of people. In certain cases this depression can be caused by a cognitive deficiency, and by learning improvements to these affected cognitive abilities it can have a positive effect on therapeutic outcome.Free Trial + Training
Major depression is a disabling condition which adversely affects a person’s family, work or school life, sleeping and eating habits, and general health (Doris et al., 1999). In the United States, approximately 3.4% of people with major depression commit suicide, and up to 60% of people who commit suicide have depression or another mood disorder. Regardless of whether the causal factors of a depressive illness are genetic or environmental, both produce physiologic changes in the neurotransmitter levels within the brain.
Depressive disorders are a huge public health problem, affecting millions of people worldwide. In the United States alone, the cost of depression is estimated at 84 billion dollars in treatment and indirect costs, such as lost productivity and absenteeism.
Major depression is associated with a wide range of symptoms that vary from one individual to another. They may include being persistently sad, anxious, angry or irritable, feelings of hopelessness, worthlessness and guilt, insomnia, oversleeping, loss of interest or pleasure in hobbies, changes in appetite and weight, thoughts of death or suicide and restlessness. Not everyone who is depressed or manic experiences every symptom. Some people experience only a few symptoms while others may experience many of these “warning signs;” the severity of these symptoms can also vary widely. Individuals suffering from major depression may also have noticeable deficits in cognitive function (Austin et al., 1999; Goodwin, 1996;Veiel, 1997), including difficulty concentrating, remembering, and making decisions.
While Major Depressive Disorder (MDD) is typically characterized as a disorder of affect, empirical and clinical studies suggest a notable deficit in cognitive function across several domains (Elliott, 2002). Depressed individuals not only exhibit dysfunction in cognitive constructs, but also show impairment in the more general qualitative and quantitative aspects of how information is processed, interpreted, and stored (Weingartner et al., 1981).
In addition, the cognitive deficits noted in patients with MDD vary both in nature and severity, and may include difficulties with a multitude of cognitive constructs, such as learning, attention, and concentration, “effortful” cognitive function, and information processing speed.
It is widely accepted that during an episode, patients with MDD show cognitive deficits in several domains. Neuropsychological deficits have been demonstrated in memory, verbal and nonverbal learning, selective and sustained attention, alertness (simple reaction time on tasks), and executive functions, such as cognitive flexibility, problem-solving, planning, and monitoring (Austin et al., 1992; Veiel, 1997; Zakzanis et al.,1998; Ottowitz et al., 2002).
In summary, individuals suffering from MDD may demonstrate difficulties with the following cognitive functions:
An improvement in cognitive abilities will have a positive effect on therapeutic outcome. Regained attention and executive functions can improve successful coping with everyday life and may therefore reduce risk of relapse (Grafman and Litvan, 1999).
Within other mental disorders, neurocognitive training has already been shown to yield such effects. For instance, in brain damaged patients, general improvement of cognitive functions (including memory, attention, executive functions, visuoconstruction) can be accompanied by an improved ability to manage common social situations and the development of compensatory strategies (Robertson, 2002; Robertson and Murre, 1999).
Cognitive remediation through the medium of interactive games can be used as an effective therapy tool. Case studies suggest the importance of psycho-education, that is ensuring that patients understand the link between cognitive exercises and their relationship to everyday life tasks and the difficulties they encounter.
Because depressed patients often suffer from a lack of self confidence, motivation, or a deep sadness, they may not see or understand a situation objectively. They may complain of memory problems (often their first complaint), however they may find it difficult to understand why they must train or improve their cognitive skills. It is however important that the therapy not only involve cognitive exercises in which patients have deficits. Better outcomes have been observed when including exercises in which the patient does not have difficulties and in which they may perform very well. This is often done to underline their cognitive strengths and to provide positive feedback and encouragement. The role of the therapist or clinician is very important in the choice of the exercises, session participation, and psychoeducation (of patients and relatives). A strong therapist-patient relationship is key for program compliance and success.
Page last updated on Oct 31,2017