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No change in neuropsychological dysfunction or emotional processing during treatment of major depression with cognitive–behaviour therapy or schema therapy

Published online by Cambridge University Press:  08 October 2015

R. J. Porter ,
C. Bourke ,
J. D. Carter ,
K. M. Douglas ,
V. V. W. McIntosh ,
J. Jordan ,
P. R. Joyce  and
C. M. A. Frampton
R. J. Porter*
Affiliation:
Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
C. Bourke
Affiliation:
Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
J. D. Carter
Affiliation:
Department of Psychology, University of Canterbury, Christchurch, New Zealand
K. M. Douglas
Affiliation:
Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
V. V. W. McIntosh
Affiliation:
Department of Psychological Medicine, University of Otago, Christchurch, New Zealand Clinical Research Unit, Canterbury District Health Board, Christchurch, New Zealand
J. Jordan
Affiliation:
Department of Psychological Medicine, University of Otago, Christchurch, New Zealand Clinical Research Unit, Canterbury District Health Board, Christchurch, New Zealand
P. R. Joyce
Affiliation:
Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
C. M. A. Frampton
Affiliation:
Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
*
*Address for correspondence: R. Porter, Department of Psychological Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch 8140, New Zealand. (Email: [email protected])
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Abstract

Background

Impaired neuropsychological functioning is a feature of major depression. Previous studies have suggested that at least some aspects of neuropsychological functioning improve with successful treatment of major depression. The extent to which medications may affect the degree of normalization of these functions is unclear. The aim of the current study was to examine the course of neuropsychological functioning during treatment of major depression with cognitive–behaviour therapy (CBT) or schema therapy (ST).

Method

A total of 69 out-patients with a primary diagnosis of major depression and 58 healthy controls completed mood ratings, neuropsychological measures, and measures of emotional processing at baseline and after 16 weeks. Participants were randomized after baseline assessment to a year-long course of CBT or ST. Patients reassessed at 16 weeks were medication-free throughout the study.

Results

Significant neuropsychological impairment was evident at baseline in depressed participants compared with healthy controls. After 16 weeks of psychotherapy, mean depression rating scores fell more than 50%. However, no neuropsychological measures showed convincing evidence of significant improvement and emotional processing did not change.

Conclusions

Persisting impairment in neuropsychological functioning after the first 16 weeks of CBT or ST suggests a need to modify psychological treatments to include components targeting cognitive functioning.

Keywords

Facial emotion processingmajor depressive disordermemoryneuropsychological functionpsychological treatment
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 2 , January 2016 , pp. 393 - 404
Copyright
Copyright © Cambridge University Press 2015 

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