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Cognitive remediation following electroconvulsive therapy in patients with treatment resistant depression : randomized controlled trail of an intervention for relapse prevention : study protocol

Nele Van de Velde (UGent) , Mitchel Kappen (UGent) , Ernst Koster (UGent) , Kristof Hoorelbeke (UGent) , Hannelore Tandt (UGent) , Pieter Verslype (UGent) , Chris Baeken (UGent) , Rudi De Raedt (UGent) , Gilbert Lemmens (UGent) and Marie-Anne Vanderhasselt (UGent)
(2020) BMC PSYCHIATRY. 20(1).
Author
Organization
Abstract
Background: Major depressive episode (MDE) is worldwide one of the most prevalent and disabling mental health conditions. In cases of persistent non-response to treatment, electroconvulsive therapy (ECT) is a safe and effective treatment strategy with high response rates. Unfortunately, longitudinal data show low sustained response rates with 6-month relapse rates as high as 50% using existing relapse prevention strategies. Cognitive side effects of ECT, even though transient, might trigger mechanisms that increase relapse in patients who initially responded to ECT. Among these side effects, reduced cognitive control is an important neurobiological driven vulnerability factor for depression. As such, cognitive control training (CCT) holds promise as a non-pharmacological strategy to improve long-term effects of ECT (i.e., increase remission, and reduce depression relapse). Method/design: Eighty-eight patients aged between 18 and 70 years with MDE who start CCT will be included in this randomized controlled trial (RCT). Following (partial) response to ECT treatment (at least a 25% reduction of clinical symptoms), patients will be randomly assigned to a computer based CCT or active placebo control. A first aim of this RCT is to assess the effects of CCT compared to an active placebo condition on depression symptomatology, cognitive complaints, and quality of life. Secondly, we will monitor patients every 2 weeks for a period of 6 months following CCT/active placebo, allowing the detection of potential relapse of depression. Thirdly, we will assess patient evaluation of the addition of cognitive remediation to ECT using qualitative interview methods (satisfaction, acceptability and appropriateness). Finally, in order to further advance our understanding of the mechanisms underlying effects of CCT, exploratory analyses will be conducted using video footage collected during the CCT/active control phase of the study. Discussion: Cognitive remediation will be performed following response to ECT, and an extensive follow-up period will be employed. Positive findings would not only benefit patients by decreasing relapse, but also by increasing acceptability of ECT, reducing the burden of cognitive side-effects.
Keywords
QUALITY-OF-LIFE, PSYCHOMETRIC PROPERTIES, MAJOR DEPRESSION, RUMINATION, MEMORY, SCALE, PHARMACOTHERAPY, STIMULATION, INVENTORY, REMISSION, Electroconvulsive therapy, Cognitive remediation, Major depression

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MLA
Van de Velde, Nele, et al. “Cognitive Remediation Following Electroconvulsive Therapy in Patients with Treatment Resistant Depression : Randomized Controlled Trail of an Intervention for Relapse Prevention : Study Protocol.” BMC PSYCHIATRY, vol. 20, no. 1, 2020, doi:10.1186/s12888-020-02856-x.
APA
Van de Velde, N., Kappen, M., Koster, E., Hoorelbeke, K., Tandt, H., Verslype, P., … Vanderhasselt, M.-A. (2020). Cognitive remediation following electroconvulsive therapy in patients with treatment resistant depression : randomized controlled trail of an intervention for relapse prevention : study protocol. BMC PSYCHIATRY, 20(1). https://doi.org/10.1186/s12888-020-02856-x
Chicago author-date
Van de Velde, Nele, Mitchel Kappen, Ernst Koster, Kristof Hoorelbeke, Hannelore Tandt, Pieter Verslype, Chris Baeken, Rudi De Raedt, Gilbert Lemmens, and Marie-Anne Vanderhasselt. 2020. “Cognitive Remediation Following Electroconvulsive Therapy in Patients with Treatment Resistant Depression : Randomized Controlled Trail of an Intervention for Relapse Prevention : Study Protocol.” BMC PSYCHIATRY 20 (1). https://doi.org/10.1186/s12888-020-02856-x.
Chicago author-date (all authors)
Van de Velde, Nele, Mitchel Kappen, Ernst Koster, Kristof Hoorelbeke, Hannelore Tandt, Pieter Verslype, Chris Baeken, Rudi De Raedt, Gilbert Lemmens, and Marie-Anne Vanderhasselt. 2020. “Cognitive Remediation Following Electroconvulsive Therapy in Patients with Treatment Resistant Depression : Randomized Controlled Trail of an Intervention for Relapse Prevention : Study Protocol.” BMC PSYCHIATRY 20 (1). doi:10.1186/s12888-020-02856-x.
Vancouver
1.
Van de Velde N, Kappen M, Koster E, Hoorelbeke K, Tandt H, Verslype P, et al. Cognitive remediation following electroconvulsive therapy in patients with treatment resistant depression : randomized controlled trail of an intervention for relapse prevention : study protocol. BMC PSYCHIATRY. 2020;20(1).
IEEE
[1]
N. Van de Velde et al., “Cognitive remediation following electroconvulsive therapy in patients with treatment resistant depression : randomized controlled trail of an intervention for relapse prevention : study protocol,” BMC PSYCHIATRY, vol. 20, no. 1, 2020.
@article{8679136,
  abstract     = {Background: Major depressive episode (MDE) is worldwide one of the most prevalent and disabling mental health conditions. In cases of persistent non-response to treatment, electroconvulsive therapy (ECT) is a safe and effective treatment strategy with high response rates. Unfortunately, longitudinal data show low sustained response rates with 6-month relapse rates as high as 50% using existing relapse prevention strategies. Cognitive side effects of ECT, even though transient, might trigger mechanisms that increase relapse in patients who initially responded to ECT. Among these side effects, reduced cognitive control is an important neurobiological driven vulnerability factor for depression. As such, cognitive control training (CCT) holds promise as a non-pharmacological strategy to improve long-term effects of ECT (i.e., increase remission, and reduce depression relapse).

Method/design: Eighty-eight patients aged between 18 and 70 years with MDE who start CCT will be included in this randomized controlled trial (RCT). Following (partial) response to ECT treatment (at least a 25% reduction of clinical symptoms), patients will be randomly assigned to a computer based CCT or active placebo control. A first aim of this RCT is to assess the effects of CCT compared to an active placebo condition on depression symptomatology, cognitive complaints, and quality of life. Secondly, we will monitor patients every 2 weeks for a period of 6 months following CCT/active placebo, allowing the detection of potential relapse of depression. Thirdly, we will assess patient evaluation of the addition of cognitive remediation to ECT using qualitative interview methods (satisfaction, acceptability and appropriateness). Finally, in order to further advance our understanding of the mechanisms underlying effects of CCT, exploratory analyses will be conducted using video footage collected during the CCT/active control phase of the study.

Discussion: Cognitive remediation will be performed following response to ECT, and an extensive follow-up period will be employed. Positive findings would not only benefit patients by decreasing relapse, but also by increasing acceptability of ECT, reducing the burden of cognitive side-effects.},
  articleno    = {453},
  author       = {Van de Velde, Nele and Kappen, Mitchel and Koster, Ernst and Hoorelbeke, Kristof and Tandt, Hannelore and Verslype, Pieter and Baeken, Chris and De Raedt, Rudi and Lemmens, Gilbert and Vanderhasselt, Marie-Anne},
  issn         = {1471-244X},
  journal      = {BMC PSYCHIATRY},
  keywords     = {QUALITY-OF-LIFE,PSYCHOMETRIC PROPERTIES,MAJOR DEPRESSION,RUMINATION,MEMORY,SCALE,PHARMACOTHERAPY,STIMULATION,INVENTORY,REMISSION,Electroconvulsive therapy,Cognitive remediation,Major depression},
  language     = {eng},
  number       = {1},
  pages        = {12},
  title        = {Cognitive remediation following electroconvulsive therapy in patients with treatment resistant depression : randomized controlled trail of an intervention for relapse prevention : study protocol},
  url          = {http://dx.doi.org/10.1186/s12888-020-02856-x},
  volume       = {20},
  year         = {2020},
}

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