S130 Psychiatria Danubina, 2012; Vol. 24, Suppl. 1, pp 130–134 Conference paper © Medicinska naklada - Zagreb, Croatia IMPACT OF PSYCHOTHERAPY AND ANTIDEPRESSIVE TREATMENT ON COGNITIVE FUNCTIONS IN PATIENTS TREATED FOR DEPRESSION Adam Klasik 1 , Krzysztof Krysta 2 & Marek Krzystanek 2 1 Institute of Psychology, University of Opole, Poland 2 Department of Psychiatry and Psychotherapy, Medical University of Silesia, Katowice, Poland SUMMARY Background: Depressive disorders are often treated with the use of antidepressants and with psychotherapy at the same time. According to the literature these two types of treatment may exert a certain influence on brain functioning. The aim of this study was to evaluate the effectiveness of different forms of therapeutic methods on the improvement of cognitive functions. Subjects and methods: 60 patients participated in the study. They were divided into 3 groups treated with pharmacotherapy, psychotherapy or both, respectively. The neuropsychological changes observed as a results of the application of these methods was assessed with the Vienna Test System (VTS). The patients recruited to the study were treated at the psychotherapeutic subdivision of a psychiatric ward. Inclusion in the study was restricted to individuals with a diagnosis of recurrent depressive disorder. Results: The improvement in psychological tests measuring short-term memory and attention was present on average after 8 weeks of treatment and was most prominent in patients treated with both forms of therapy. Conclusions: The interpretation of the achieved results must be cautious because of the relatively small groups participating in the study. Further research is necessary to analyze the impact of different therapeutic forms used in the treatment of depression on cognitive processes. Key words: antidepressants – psychotherapy - cognitive functions * * * * * INTRODUCTION So far there have been many observations that de- pressive disorders are associated with the presence of cognitive dysfunctions. Cognitive deficits are found in depressive episodes of affective disorders such as major depressive disorder and bipolar disorder (Hammar & Ardal 2009, Godart et al. 2010, Kałwa 2011). However the association between depression severity and neurocognitive functioning still remains not fully understood, and the results of the studies related to this problem are inconsistent (McClintock et al. 2007). It is hypothesized that there are many different factors e.g. clinical, demographic and neurobiological, which have an impact on the severity and profile of cognitive impairments (Beblo et al. 2011). In the literature there are a number of reports presenting advantageous effect of antidepressants on cognitive deficits in depression. Constant et al. (2005) found out that treatment with sertraline had a beneficial effect on psychomotor slowing and on attentional and executive functions in 20 young depressed patients. Improvement of psychomotor slowing after treatment with sertraline was found also in other studies (Schrijvers et al. 2009). Partial improve- ment in the studied cognitive functions was achieved, and no differences between patients treated with fluoxetine and reboxetine was found in a study evaluating attention and memory functions during a major depression episode and in remission (Galassi et al. 2006). In another study escitalopram and duloxetine turned out to effectively improve the deficits of attention and executive functions (Herrera-Guzmán 2010), as well as of memory and mental processing speed (Herrera-Guzmán 2009). In our own study we found that a 3-month treatment with tianeptine led to the improvement of attention and short-term memory in patients with mild and moderate depression (Klasik et al. 2011). In the literature there is a group of available findings from neuroimaging studies that both psychotherapy and pharmacotherapy may exert a similar influence on the neurobiology of the brain. It has been observed that completion of successful cognitive- behavioral therapy in a group of 12 patients with panic disorder may cause reduction of the baseline hyper- activity in several brain areas and adaptive metabolic changes of the medial prefrontal cortices (Sakai et al. 2006). Positive changes in brain activity including the modulation of limbic and cortical regions were observed in patients with unipolar depression treated with CBT (Goldapple et al. 2004). Similar changes in brain meta- bolism were found after treatment either with CBT or with antidepressants in patients suffering from panic disorder (Prasko et al. 2004) and from social phobia (Furmank et al. 2002). In some studies certain differences in the effect of both treatment methods are reported. In a study comparing the results of the treatment with CBT and venlafaxine in a group of patients with major depressive disorder (MDD) it was found that CBT modulates cortical-limbic connectivity and venlafaxine engages additional cortical and striatal regions (Kennedy et al. 2007). We have already had our own observations that both psychotherapy and pharma-