Improving Depression Outcome by Enhancing Memory for Cognitive Therapy

描述（由申请人提供）：重度抑郁症（MDD）是世界上最常见的精神疾病之一，也是导致残疾的主要原因之一。现有的治疗方法不能完全恢复。改善结果的进展必须包括安全、有效、廉价和简单（以便快速有效传播）的创新。拟议中的研究旨在测试这样一种创新。我们试图通过改善认知治疗（CT）会话内容的记忆来改善结果。CT是治疗重度抑郁症最有希望的方法之一，但仍有改进的余地。我们认为，在CT中加入记忆增强策略可能会改善MDD的结果，因为：(a) MDD通常以记忆障碍为特征，(b)有证据表明记忆障碍是可以改变的，(c) CT通常需要激活情绪，(d)情绪会损害或影响记忆，(e)有证据表明对治疗内容的记忆很差。的目标。为了评估一种新的策略是否能改善重度抑郁症的治疗效果，该策略来源于记忆文献，旨在增强对CT课程内容的记忆。认知支持包括一系列支持情景记忆的编码和检索阶段的特定过程。假设CT+认知支持，相对于常规CT，将与治疗结束时和治疗完成后6个月的抑郁预后改善有关。研究计划。第一阶段包括通过测试成年重度抑郁症患者的治疗方法来开发和完善认知支持干预的迭代过程（n = 8）。在第二阶段，将对患有重度抑郁症的成年人（n = 48）进行一项小型试点可行性RCT，他们将被随机分为：(a) CT+认知支持（n = 24）或(b) CT-as-usual （n = 24）。结果测量将在基线、治疗结束和治疗后6个月进行。长期目标。如果结果是积极的，将对公共卫生产生重大影响，因为简单、廉价的记忆增强策略可以很容易地作为一种标准特征纳入所有针对广泛精神疾病的社会心理治疗中。作为实现这一目标的第一步，本研究将提供所需的试点数据，以准备更大规模的干预研究，重点是通过改善对重度抑郁症治疗内容的记忆来改善结果。

DESCRIPTION (provided by applicant): Major depressive disorder (MDD) is one of the most prevalent psychiatric disorders and a leading cause of disability worldwide. Existing therapies fail to produce complete recovery. Progress toward improving outcome must include innovations that are safe, powerful, inexpensive and simple (for fast and effective dissemination). The proposed research seeks to test one such innovation. We seek to improve outcome by improving memory for the content of cognitive therapy (CT) sessions. CT is one of the most promising approaches to the treatment of MDD, yet there is room for improvement. We believe that adding memory enhancing strategies to CT may improve MDD outcome because: (a) MDD is often characterized by memory impairment, (b) there is evidence that the memory impairment is modifiable, (c) CT typically entails the activation of emotion, (d) emotion can impair or bias memory and (e) there is evidence that memory for the content of therapy sessions is poor. Aim. To evaluate if the addition of a novel strategy, derived from the memory literature and designed to enhance memory for the content of CT sessions, will improve treatment outcome for MDD. Cognitive support involves a series of specific procedures that support the encoding and retrieval stages of an episodic memory. It is hypothesized that CT+Cognitive Support, relative to CT-as-usual, will be associated with improved depression outcome at the end of treatment and 6 months after the completion of treatment. Research Plan. Phase 1 involves an iterative process of developing and refining the cognitive support intervention by testing the treatment with adults with MDD (n = 8). In Phase 2, a small pilot feasibility RCT will be conducted on adults with MDD (n = 48) who will be randomized to either: (a) CT+Cognitive Support (n = 24) or (b) CT-as-usual (n = 24). Outcome measures will be taken at baseline, end of treatment, and 6 months after treatment. Long-term objective. The outcomes, if positive, will have major public health implications because simple, inexpensive memory enhancing strategies can be readily included as a standard feature in all psychosocial treatments for a broad range of mental illness. As a first step toward achieving this goal, this research will provide the pilot data needed to prepare a larger scale intervention study focused on improving outcomes by improving memory for the content of therapy sessions in MDD.