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Original Article

Neuropsychological Predictors of the Clinical Response to Cognitive-Behavioral Therapy in Patients with Major Depression

Published Online:https://doi.org/10.1024/1016-264X/a000130

Aim of the study was to identify neuropsychological predictors of the clinical response to cognitive behavioral therapy (CBT) in patients with major depression. 19 unmedicated patients underwent neuropsychological testing at baseline and subsequently were assigned randomly to CBT over 3 weeks either as monotherapy or combined with sleep deprivation (SD) therapy (two nights of total SD / week). Hierarchical regression analysis revealed that parameters of declarative verbal memory and a word fluency task predicted the clinical response (percentage improvement of Hamilton depression scores) to CBT monotherapy, whereas no such prediction was obtained in the combination group. The results suggest that certain cognitive performances have a unique predictive value for the response to CBT, which appears to be abolished by additive treatments with cognitive side effects (e. g. SD).


Neuropsychologische Prädiktoren des klinischen Ansprechens auf kognitive Verhaltenstherapie bei Patienten mit Majorer Depression

Ziel der Studie war die Identifikation von neuropsychologischen Prädiktoren für das klinische Ansprechen auf kognitive Verhaltenstherapie (KVT) bei Patienten mit Majorer Depression. 19 medikamentös unbehandelte Patienten durchliefen zu Baseline eine neuropsychologische Testbatterie, danach wurde – entsprechend Randomisierung – eine KVT über 3 Wochen entweder als Monotherapie oder als Kombinationsbehandlung mit Schlafentzugstherapie (zwei vollständige Schlafentzüge / Woche) durchgeführt. Eine hierarchische Regressionsanalyse zeigte, dass Parameter des deklarativen Verbalgedächtnisses und einer Wortflüssigkeitsaufgabe signifikante Prädiktoren des Ansprechens (prozentuale Verbesserung der Hamilton-Depressionswerte) auf KVT als Monotherapie waren, während ein entsprechender Vorhersagewert bei der Kombinationsbehandlung nicht hervorging. Die Ergebnisse deuten an, dass bestimmten kognitiven Funktionsleistungen depressiver Patienten ein eigenständiger Vorhersagewert für das Ansprechen auf KVT zukommt, wobei dieser bei additiver Implementierung von Therapien mit bekannten kognitiven Nebenwirkungen (z. B. Schlafentzug) aufgehoben scheint.

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