A Secondary Analysis of Longitudinal Pilot-Study Data Investigating the Associations Between Health-Related Quality of Life and Executive Functions in Remitted Major Depressive Disorder and Developments Two-Years Following Cognitive Training.

Abstract

Major depressive disorder (MDD) is associated with reduced quality of life and relapse risk. However, few studies have investigated how quality of life is associated with cognitive deficits following MDD and is affected by cognitive training. This study investigated the long-term effects of computer-based working memory training (CWMT) on health-related quality of life (HRQL) in remitted MDD, and the association between executive functions (EF) and HRQL. Twenty-nine remitted participants (M age 36.21, SD = 10.8) were included in a pre-post pilot study of CWMT with 1- and 2-year follow-up. Twenty participants completed 5 weeks of CWMT, 12 participants were included at the 1-year follow-up, and 10 participants returned for the 2-year follow-up. The 36-item Short-Form Health Survey was used to assess HRQL. Associations between subjective and objective cognitive EF and HRQL were measured by the Behavior Rating Inventory of Executive Function for Adults (BRIEF-A) and a neuropsychological test battery of EF. Significant moderate improvements were found in aspects of HRQL after 2 years (d = 0.66). There were negative correlations between HRQL and BRIEF-A pre-intervention (r = 0.47-0.65). However, the study did not find significant associations between improved EF and improved HRQL. Preliminary results indicate long-term improvements in HRQL following CWMT. Subjective EF deficits were associated with poorer HRQL. However, due to limitations including small sample size and multiple statistical comparisons, larger controlled studies are needed to investigate and replicate the potential effects of CWMT on HRQL.