Computerized cognitive training and functional recovery in major depressive disorder: A meta-analysis

- Systematic review found 9 randomized trials of CCT for depression.
- CCT was associated with improvement in depressive symptoms and everyday functioning.
- CCT improved working memory, attention, and global functioning.
- No effect of CCT for verbal memory or executive functioning.

ObjectiveDepression is common, frequently resistant to antidepressant treatment, and associated with impairments in cognition and everyday functioning. Computerized cognitive training (CCT) paradigms offer potential to improve cognition, mood and everyday functioning, but their effectiveness is not well established. The goal of this article was to conduct a systematic review and meta-analysis to determine the efficacy of CCT in depressive disorders.MethodA search was conducted to identify high quality randomized controlled CCT trials per PRISMA guidelines using PsycINFO and MEDLINE with the keywords “Cognitive training” or “Cognitive remediation” or “Cognitive rehabilitation” and “Depression”. 9 randomized trials for depressed adults met inclusion criteria. Effect sizes (Hedge's g) were calculated for key outcome measures of mood symptom severity, daily functioning, and cognition. A 3-level Bayesian hierarchical linear model was used to estimate effect sizes for each domain and study. Publication bias was assessed using Classic Fail Safe N's and homogeneity was evaluated using Q and I2 indexes.ResultsSignificant small-moderate effects for Symptom Severity (0.43) and Daily Functioning (0.72), and moderate-large effects for Attention (0.67), Working Memory (0.72), and Global Functioning (1.05) were found. No significant effects were found for Executive Functioning or Verbal Memory. Moderator variable analysis revealed decreased effect of CCT with age. Gender and concurrent medication treatment did not affect the results.LimitationsSmall sample size, short duration, pseudo-specificity, and high heterogeneity for Verbal Memory measures.ConclusionsCCT is associated with improvement in depressive symptoms and everyday functioning, though produces inconsistent effects on cognition.