Cognitive remediation for treatment-resistant depression: effects on cognition and functioning and the role of online homework

J Nerv Ment Dis. 2013 Aug;201(8):680-5. doi: 10.1097/NMD.0b013e31829c5030.


Neurocognitive impairments are observed in depression and associated with poor functioning. This study examined the efficacy and the effectiveness of cognitive remediation with supplemental Internet-based homework in treatment-resistant depression. Participants were randomized to treatment or wait list control conditions. Treatment consisted of 10 weeks of weekly group sessions and daily online cognitive exercises completed at home. The participants were assessed on cognitive, mood, motivation, and functioning measures. There was a significant time by treatment interaction for attention/processing speed and verbal memory. Changes in functioning were not significant, although improved cognition predicted improvements in functioning. Number of minutes of online exercise was associated with greater cognitive improvements. Cognitive deficits are malleable with behavioral treatment in a mood disorder characterized by severe and persistent symptoms.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological / physiology
  • Adult
  • Cognition Disorders / etiology
  • Cognition Disorders / therapy*
  • Cognitive Behavioral Therapy / instrumentation
  • Cognitive Behavioral Therapy / methods*
  • Depressive Disorder, Major / complications
  • Depressive Disorder, Major / therapy*
  • Depressive Disorder, Treatment-Resistant / complications
  • Depressive Disorder, Treatment-Resistant / therapy*
  • Female
  • Humans
  • Internet / statistics & numerical data
  • Male
  • Middle Aged
  • Severity of Illness Index
  • Social Adjustment
  • Time Factors
  • Treatment Outcome