RehaCom applied in depression remediation therapy

 RehaCom Software for cognitive rehabilitation

RehaCom Software for cognitive rehabilitation

RehaCom software is of value in certain psychiatric domains.  In a 2015 paper presented at the European Psychiatry conference, Semkovska and colleagues described their study with the objective to conduct two randomised controlled pilot studies. The objective was to determine both the feasibility and efficacy of neurocognitive remediation therapy (NCRT) using RehaCom in two groups

  • acutely depressed, hospitalised patients; and 
  • community-living remitters from recurrent depression,

This is interesting because major depression is the most prevalent psychiatric disorder with high relapse rates. The ability to effectively support people in the community would be an important finding.    According to the authors, the problem following routine treatment is that mood may improve but neurocognitive difficulties often persist, preventing a full return to normal social function. These deficits worsen with repeated depressive episodes and are a significant predictor of relapse. 

The efficacy of NCRT to rehabilitate cognition has been demonstrated in several neurological and psychiatric populations but randomised controlled trials (RCT) have not been conducted in depression.

In the first pilot, 24 persons who were hospitalised for major depression were randomised to either

  • computerised NCRT using RehaCom or
  • playing computer games 

The sessions were for five weeks with four one-hour individual sessions weekly.  The NCRT software utilised the RehaCom procedures focused on divided attention, working memory and planning.

In the second pilot study, 20 community-living remitters from recurrent depression were randomised to the same interventions, but their administration was home-based from the programme start.  

In both studies, before the intervention start and within a week of the final session, standardised assessments of cognition and depression severity were conducted.

The feasibility assessment demonstrated good recruitment and compliance rates, with excellent acceptance of randomisation.  Preliminary outcome data showed improvement in 80% of the targeted cognitive domains following NCRT comparatively to the control condition.

The authors conclude that their pilot studies support the feasibility and value of conducting an RCT of computerised NCRT for neurocognitive deficits in both acutely depressed and remitted individuals.

References
“Efficacy of Neurocognitive Remediation Therapy During an Acute Depressive Episode and Following Remission: Results From Two Randomised Pilot Studies” CONFERENCE PAPER in EUROPEAN PSYCHIATRY 30:403 · MARCH 2015

“Neurocognitive Remediation Therapy for Depression: A Feasibility Study and Randomized Controlled Pilot Protocol Testing” ARTICLE in THE JOURNAL OF NERVOUS AND MENTAL DISEASE · JULY 2015

Authors
M. Semkovska (1), E. Ahern(1), D. O Lonargáin(2), S. Lambe(2), D.M. McLaughlin(2)

(1)Psychology, University of Limerick, Limerick, Ireland ; 
(2)Psychiatry, Trinity College Dublin, Dublin, Ireland