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Aust N Z J Psychiatry. 2013 Dec;47(12):1165-75. doi: 10.1177/0004867413502090. Epub 2013 Aug 16.

Cognitive remediation as a treatment for major depression: A rationale, review of evidence and recommendations for future research.

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1Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.



There is considerable literature regarding the effectiveness of cognitive remediation (CR) in schizophrenia and in conditions such as stroke and traumatic brain injury. Patients with major depressive disorder (MDD) present with significant cognitive impairment which in many cases may not resolve with treatment. Neurobiological data suggest that this may relate to underlying dysfunction of pre-frontal cortical areas of the brain and their connections with limbic structures. There has been limited research into specific CR to activate these areas and target impaired cognitive function in MDD. We therefore review current evidence, examine the theoretical basis for and present a rationale for research into CR in MDD. In addition, we will examine important methodological issues in developing such an approach.


Based on preliminary studies using CR-based techniques, data from CR in schizophrenia, data regarding baseline and residual cognitive impairment in depression, and knowledge of the neurobiology of MDD, we examine the possible utility of CR strategies in the treatment of MDD and make recommendations for research in this area.


A small number of previous studies have examined specific CR in MDD. The studies are small and inconclusive. However, data on the neuropsychological function and neurobiology of MDD suggest that this is an approach that deserves further attention and research.


Further research is required in carefully selected populations, using well-defined CR techniques and some form of comparator treatment.


Cognition; depression; mood disorder; treatment

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