Negative cognitive schema modification as mediator of symptom improvement after electroconvulsive therapy in major depressive disorder
| Autor: | Dominique S. Scheepens, Jeroen A. van Waarde, Freek ten Doesschate, Mirjam Westra, Marijn C.W. Kroes, Aart H. Schene, Robert A. Schoevers, Damiaan Denys, Henricus G. Ruhé, Guido A. van Wingen |
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| Přispěvatelé: | Clinical Cognitive Neuropsychiatry Research Program (CCNP), Interdisciplinary Centre Psychopathology and Emotion regulation (ICPE), Adult Psychiatry, Amsterdam Neuroscience - Brain Imaging, Amsterdam Neuroscience - Compulsivity, Impulsivity & Attention, APH - Mental Health |
| Rok vydání: | 2022 |
| Předmět: |
Psychiatric Status Rating Scales
Depressive Disorder Major Stress-related disorders Donders Center for Medical Neuroscience [Radboudumc 13] Major depressive disorder Depressive Disorder Treatment-Resistant Psychiatry and Mental health Clinical Psychology Cognition Treatment Outcome All institutes and research themes of the Radboud University Medical Center Electroconvulsive therapy Humans Emotional memory reactivation Negative schemas |
| Zdroj: | Journal of Affective Disorders, 310, 156-161 Journal of Affective Disorders, 310, pp. 156-161 Journal of Affective Disorders, 310, 156-161. ELSEVIER SCIENCE BV Journal of affective disorders, 310, 156-161. Elsevier |
| ISSN: | 0165-0327 |
| Popis: | Background: Electroconvulsive therapy (ECT) is a potent option for treatment-resistant major depressive disorder (MDD). Cognitive models of depression posit that negative cognitions and underlying all-or-nothing negative schemas contribute to and perpetuate depressed mood. This study investigates whether ECT can modify negative schemas, potentially via memory reactivation, and whether such changes are related to MDD symptom improvement.Method: Seventy-two patients were randomized to either an emotional memory reactivation electroconvulsive therapy (EMR-ECT) or control memory reactivation electroconvulsive therapy (CMR-ECT) intervention prior to ECT-sessions in a randomized controlled trail. Emotional memories associated with patients' depression were reactivated before ECT-sessions. At baseline and after the ECT-course, negative schemas and depression severity were assessed using the Dysfunctional Attitude Scale (DAS) and Hamilton Depression Rating Scale HDRS. Mediation analyses were used to examine whether the effects of ECT on HDRS-scores were mediated by changes in DAS-scores or vice versa.Results: Post-ECT DAS-scores were significantly lower compared to baseline. Post-ECT, the mean HDRS-score of the whole sample (15.10 ± 8.65 [SD]; n = 59) was lower compared to baseline (24.83 ± 5.91 [SD]). Multiple regression analysis showed no significant influence of memory reactivation on schema improvement. Path analysis showed that depression improvement was mediated by improvement of negative cognitive schemas.Conclusion: ECT is associated with improvement of negative schemas, which appears to mediate the improvement of depressive symptoms. An emotional memory intervention aimed to modify negative schemas showed no additional effect. |
| Databáze: | OpenAIRE |
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