Cognitive Rehabilitation for Depression

Overseen By Joren Adams

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Portland VA Medical Center

Disqualifiers: TBI, Substance use, Dementia, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 10

Duration: 8 weeks

24 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to help Veterans who have received treatment for major depressive disorder (MDD) but continue to experience thinking and memory problems. It will test whether an 8-week program called Motivationally Enhanced Compensatory Cognitive Training (ME-CCT-MDD) can improve their mental skills and quality of life. Participants will be randomly assigned to either this program or a similar one focused on setting and achieving goals, known as Goal-focused Supportive Contact. Veterans treated for MDD in the past year who have ongoing memory or attention issues might be a good fit for this trial. As an unphased trial, it offers Veterans the chance to explore innovative approaches to enhance mental skills and quality of life.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the study staff or your healthcare provider.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that Motivationally Enhanced Compensatory Cognitive Training for Major Depressive Disorder (ME-CCT-MDD) is generally safe and well-tolerated. Studies have found that similar programs improve attention, memory, and overall thinking skills without causing serious side effects. Participants often notice better daily functioning and mental performance.

As a non-drug treatment, ME-CCT-MDD doesn't carry the same risks as medication. It focuses on teaching ways to handle stress and enhance thinking skills, minimizing the risk of negative physical effects. The main goal is to address thinking problems that may persist after depression treatment, without causing harm.

Overall, current research suggests that this training is safe for people with depression. Participants usually find it helpful and easy to manage. While no treatment is completely without risk, existing studies indicate that ME-CCT-MDD appears to be safe. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Motivationally Enhanced Compensatory Cognitive Training for Major Depressive Disorder (ME-CCT-MDD) because it takes a unique approach by focusing on improving cognitive functioning in individuals with depression, particularly Veterans. Unlike standard treatments for depression, which often involve medication or general talk therapy, ME-CCT-MDD combines motivational techniques with cognitive training in a structured group setting. This method not only aims to alleviate depressive symptoms but also targets cognitive complaints, which are often overlooked in traditional therapies. Meanwhile, Goal-focused Supportive Contact (GSC) offers a comparable group therapy experience, emphasizing consistent support and interaction, which is essential for many individuals dealing with depression. The hope is that these innovative approaches will provide more comprehensive and effective support for those with Major Depressive Disorder.

What evidence suggests that this trial's treatments could be effective for depression-related cognitive deficits?

Research has shown that Motivationally Enhanced Compensatory Cognitive Training for Major Depressive Disorder (ME-CCT-MDD), a treatment tested in this trial, can significantly improve cognitive skills such as memory and attention in individuals with depression. Studies indicate that this training leads to moderate improvements in decision-making, learning new information, and memory retention. It may also reduce depression severity and enhance overall quality of life. This method addresses challenges that can hinder recovery from depression. Overall, early evidence suggests ME-CCT-MDD can effectively aid those experiencing cognitive difficulties due to depression. ^{2 3 6 7 8}

Who Is on the Research Team?

Maya O'Neil, PhD

Principal Investigator

Portland VA Medical Center

Joren Adams

Principal Investigator

Portland VA Medical Center

Are You a Good Fit for This Trial?

This trial is for Veterans who have been treated for Major Depressive Disorder (MDD) within the past year and are still struggling with cognitive issues like memory and concentration. Participants must be willing to undergo assessments, attend weekly group sessions for 8 weeks, and complete follow-up evaluations.

Inclusion Criteria

2. Self-reported concerns about cognitive functioning deficits or clinical concerns about cognitive functioning deficits documented in EHR

3. meets DSM-5 criteria for MDD and receiving treatment for this diagnosis at the Portland VA within the past year

4. moderate or greater depressive symptoms as assessed by a PHQ-9 score ≥ 10

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Participants undergo an assessment of cognition, symptoms, and functioning, including interviews and neuropsychological tests

1 day

1 visit (in-person)

Treatment

Participants receive either ME-CCT-MDD or GSC intervention, involving weekly group sessions for cognitive training or supportive contact

8 weeks

8 visits (in-person)

Follow-up

Participants complete a follow-up assessment of cognition, symptoms, and functioning, including a brief interview about their experience

2 weeks

1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Goal-focused Supportive Contact
• Motivationally Enhanced Compensatory Cognitive Training for Major Depressive Disorder (ME-CCT-MDD)

Trial Overview The study tests an 8-week program called Motivationally Enhanced Compensatory Cognitive Training (ME-CCT-MDD) against Goal-focused Supportive Contact (GSC). It aims to see if ME-CCT-MDD can improve thinking skills, mental health symptoms, daily functioning, and quality of life in Veterans with MDD-related cognitive deficits.

How Is the Trial Designed?

Group I: Motivationally Enhanced Compensatory Cognitive Training for Major Depressive Disorder Experimental Treatment 1 Intervention

Motivationally Enhanced Compensatory Cognitive Training for Major Depressive Disorder (ME-CCT-MDD) is a manualized group-based behavioral intervention (8 weeks, 2 hour per week) designed to improve cognitive functioning in Veterans with Major Depressive Disorder (MDD) and cognitive complaints.

Group II: Goal-focused Supportive Contact Active Control 1 Intervention

Goal-focused Supportive Contact (GSC) is a group therapy intervention that provides the same frequency (8 weeks , 2 hours per week) and amount of therapist and other group member contact as ME-CCT-MDD.

Who Is Running the Clinical Trial?

Portland VA Medical Center

Lead Sponsor

Trials

44

Recruited

7,800+

Oregon Health and Science University

Collaborator

Trials

1,024

Recruited

7,420,000+

Published Research Related to This Trial

This study aims to systematically review and analyze the efficacy of computerized cognitive training (CCT) in improving cognitive performance in adults with depression, focusing on randomized controlled trials.

The research will explore how CCT affects not only cognitive outcomes but also mood and daily functioning, making it the first comprehensive analysis of its kind in this specific clinical population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Computerized cognitive training in people with depression: a protocol for a systematic review and meta-analysis. Lampit, A., Launder, NH., Minkov, R., et al.[2022]

In a study involving 46 young adults with mild depressive symptoms, executive functioning and processing speed (EF/PS)-focused computerized cognitive training (CCT) led to greater improvements in those specific cognitive areas compared to verbal ability-focused CCT.

Both types of CCT resulted in significant improvements in mood and everyday functioning, but the EF/PS group achieved similar mood benefits with only half the training time, suggesting that the content of CCT may not be as crucial as the engagement in the training itself.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Computerized cognitive training in young adults with depressive symptoms: Effects on mood, cognition, and everyday functioning. Motter, JN., Grinberg, A., Lieberman, DH., et al.[2019]

Computerized cognitive training (CCT) using Brain HQ showed significant cognitive improvements in psychiatric rehabilitation clients, with an average increase of 4.4 points in BACS t-scores after about 17 days of training.

Higher engagement in training (measured by levels completed per day) was positively correlated with cognitive gains, suggesting that monitoring engagement can help identify patients who may need additional support to benefit from CCT.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Training engagement, baseline cognitive functioning, and cognitive gains with computerized cognitive training: A cross-diagnostic study. Harvey, PD., Balzer, AM., Kotwicki, RJ.[2020]

Citations

1. withpower.com withpower.com/trial/cognitive-rehabilitation-for-depression-efc81

Cognitive Rehabilitation for Depression · Recruiting Participants ... The investigators will compare Motivationally Enhanced Compensatory Cognitive Training for Major Depressive Disorder (ME-CCT-MDD) to a robust comparator, Goal- ...

2. centerwatch.com centerwatch.com/clinical-trials/listings/search/?q=major%20depressive%20disorder

major depressive disorder Clinical Research Trials ME-CCT-MDD is a comprehensive treatment in that it addresses multiple types of symptoms and concerns that interfere with recovery from depressed mood episodes - ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9883940/

Cognitive rehabilitation for improving cognitive functions ... We found a moderate and significant effect on the executive function, verbal learning, and working memory of patients with MDD. All of the ...

4. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0920996417304711

Compensatory cognitive training for people with severe ... We conclude that CCT has the potential to improve cognitive performance, psychiatric symptom severity, and quality of life in people with severe mental ...

5. escholarship.org escholarship.org/content/qt6wr3f1d5/qt6wr3f1d5_noSplash_353ed210bae84cf260633da36d7c8ee9.pdf

Effects of Motivationally Enhanced Compensatory ... Results from a large-scale cognitive training randomized controlled trial. (Advanced Cognitive Training for Independent and Vital Elderly ...

6. adaa.trialstoday.org adaa.trialstoday.org/?page=eJyLVspLrShR0lHycw4xMLM0szAzNVDS0bWEAR1jPUMjA0MjYx1DcxMLc2MzAzDQUcpLLjEwNzCyMDI0U4oFAEZuD9g-

Anxiety & Depression Association of America The primary objective of this pilot clinical trial is to evaluate the feasibility and acceptability of a manualized, 8-week, Compensatory Cognitive Training ( ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6178894/

Current Status of Cognitive Remediation for Psychiatric ... The results showed that, among the neurocognitive functions, attention, working memory, and overall cognitive function were improved, whereas ...

8. sciencedirect.com sciencedirect.com/science/article/pii/S266691532400091X

The effectiveness of cognitive training in people ... The findings suggest that integrating cognitive training could enhance daily functioning and cognitive performance among psychiatric patients with depressive ...