Computerized Cognitive Training in People with Depression: A Systematic Review and Meta-analysis of Randomized Clinical Trials.

Abstract

Introduction: Cognitive impairment and depression frequently co-occur, exacerbating disability. Identifying accessible interventions to enhance cognition in people with depression is imperative. Computerized cognitive training (CCT) is a potential strategy, but its clinical efficacy across settings remain unclear. We investigated the efficacy of CCT and potential moderators of cognitive and functional outcomes in individuals with depressive symptoms.

Methods: In this systematic review and meta-analysis (PROSPERO: CRD42020204209), we searched MEDLINE, Embase, and PsycINFO from inception to June 22, 2026 for randomized controlled trials (RCTs) of CCT in adults (≥18 years) with clinically significant depressive symptoms. Primary outcome was change in overall cognition. Secondary outcomes included depressive symptoms, psychosocial and daily functioning.

Results: Fifty-three 53 RCTs (3831 participants) were included. CCT was efficacious for overall cognition (49 RCTs, (g=0.23; 95% CI 0.14 to 0.32; τ2=0.095) and depressive symptoms (35 RCTs, g=0.22; 95% CI 0.08 to 0.37; τ2=0.066) with substantial heterogeneity across studies, and did not extend to psychiatric symptoms and daily function. Greater cognitive benefits were associated with multidomain training, higher doses, session durations >30 min, and ≤3 sessions per week. Efficacy was independent of baseline symptom severity, and comparable across delivery modes.

Conclusions: CCT can improve cognition, depression and subjective outcomes in people with major or comorbid depression, but efficacy varies across outcomes, settings and intervention design factors. Future work is needed to confirm these factors, and examine what approaches and dose is required to enhance cognitive and functional outcomes of CCT.