Developing an internet-delivered intervention targeting residual cognitive symptoms after major depressive disorder: a person-based approach

J Ment Health. 2022 Dec;31(6):842-850. doi: 10.1080/09638237.2021.2022618. Epub 2022 Jan 5.

Abstract

Background: Cognitive difficulties are rarely addressed after the treatment of major depressive disorder (MDD). New scalable treatments are needed. To ensure relevance and engagement of novel interventions, there is a need to understand the perspectives of the users.

Aim: Explore former depressed adults needs and perspectives during the planning and development of a novel internet-delivered intervention targeting residual cognitive symptoms after MDD.

Method: The planning phase included exploratory qualitative interviews with former depressed adults (n = 16). In the development phase, a prototype including psychoeducation, attention training and compensatory strategies was tested in think-aloud interviews with former depressed adults (n = 7) and psychologists (n = 4). Data were analysed thematically.

Results: Analysis of exploratory interviews identified four themes. Experiences of residual cognitive symptoms consisted of two sub-themes (Everyday life is more demanding; Concerns about cognitive difficulties). Coping with residual cognitive symptoms had two sub-themes (Compensatory strategies; Acceptance). Needs from an intervention consisted of two-subthemes (Need for information; Therapist support). Barriers for engagement consisted of three sub-themes (Being overwhelmed; Not being motivated; Frequent registration). Analysis of think-aloud interviews was organized into three themes: Positive perceptions of content; Concerns regarding content; Perceptions of Layout, Visuals and Navigation.

Conclusion: The intervention may address concerns and consequences of cognitive difficulties by including psychoeducation, compensatory strategies and elements to increase acceptance and motivation, provided in manageable proportions.

Keywords: cognitive enhancement therapy; cognitive impairment; cognitive remediation; depression; internet-based treatment; mood disorder; qualitative.

MeSH terms

  • Adult
  • Cognition
  • Cognitive Behavioral Therapy*
  • Depressive Disorder, Major* / therapy
  • Humans
  • Internet
  • Motivation