Perceived Deficits Questionnaire Research Articles

Cognitive impact of anticholinergic and sedative burden in people with HIV.

This study aims to estimate the extent to which anticholinergic and sedative burden is associated with cognitive ability and self-reported cognitive difficulties (SCD) in middle-aged and older adults living with HIV. This cross-sectional analysis examined data from the inaugural visit of participants enrolled in the Positive Brain Health Now (BHN) study. Cognitive ability was measured using the Brief Cognitive Ability Measure (B-CAM; higher is better) and SCD using the Perceived Deficits Questionnaire (PDQ; higher is worse). Medication burden was quantified using several scoring systems, including the Anticholinergic Cognitive Burden (ACB), Anticholinergic and Sedative Burden Catalog (ACSBC), Anticholinergic Drug Scale (ADS), Anticholinergic Risk Scale (ARS), and the Sedative Load Model (SLM). Multivariable Ordinary Least Squares and quantile regression were utilized to estimate average effects and distribution-specific impacts, respectively. Of 824 participants (mean age 53 years, 84.7% men), 41.4% used anticholinergics (ACSBC) and 39% used sedatives (SLM). High anticholinergic burden was linked to worse cognitive ability [ β = -3.81; 95% confidence interval (CI): -7.16, -0.46] and SCD ( β = 3.89; 95% CI: 1.08, 6.71). Using three or more anticholinergics worsened cognitive ability ( β = -4.45; 95% CI: -8.54, -0.35), and using three or more sedatives increased SCD ( β = 4.35; 95% CI: 0.92-7.78). Stronger negative associations were observed in participants with lower cognitive ability and more difficulties. These results suggest that anticholinergic and sedative burden may contribute to cognitive impairment in people with HIV. Personalized medication management and regular cognitive assessments could mitigate these adverse effects.

Procognitive Effects of Adjunctive D-Cycloserine to Intermittent Theta-Burst Stimulation in Major Depressive Disorder: Effets procognitifs de la D-cyclosérine en traitement complémentaire par la stimulation thêta-burst intermittente dans le trouble dépressif caractérisé.

Major depressive disorder (MDD) is associated with cognitive impairments that persist despite successful treatment. Transcranial magnetic stimulation is a noninvasive treatment for MDD that is associated with small procognitive effects on working memory and executive function. We hypothesized that pairing stimulation with N-methyl-D-aspartate (NMDA) receptor agonism would enhance the effects of stimulation and its procognitive effects. The effect of NMDA receptor agonism (D-cycloserine, 100 mg) on cognitive performance was tested in two randomized double-blind placebo-controlled trials: (1) acute effects of in the absence of stimulation (n = 20 healthy participants) and (2) a treatment study of individuals with MDD (n = 50) randomized to daily intermittent theta-burst stimulation (iTBS) with placebo or D-cycloserine for 2 weeks. Cognitive function was measured using the THINC-it battery, comprised of the Perceived Deficits Questionnaire, the Choice Reaction Time, the Trail Making Test, the Digit Symbol Substitution Test, and the 1-Back tests. D-cycloserine had no acute effect on cognition compared to placebo. iTBS + D-cycloserine was associated with significant improvements in subjective cognitive function and correct responses on the 1-Back when compared to iTBS + placebo. Improvements in subjective cognition paralleled depressive symptoms improvement, however 1-Back improvements were not attributable to improvement in depression. An intersectional strategy pairing iTBS with NMDA receptor agonism may restore cognitive function in MDD.

The THINC-it tool: temporal sensitivity to change over time

IntroductionCognitive dysfunction is believed to be among the core features of Bipolar Depression(BD-D). However, its evaluation and available treatments are limited. Here, we conducted a longitudinal follow-up clinical trial using the THINC-it tool to evaluate temporal sensitivity to change over time in cognitive function among patients with bipolar depression from a Chinese cohort. It is helpful to verify whether the scale can continuously and reliably measure cognitive function in different time points and reduce the measurement error caused by time factors. Hope our findings could provide insights into the significance of the THINC-it tool as an iterative clinical cognitive evaluation tool.MethodsA total of 120 patients with bipolar depression(40 males and 80 females, respectively) alongside 100 healthy controls(23 males and 77 females, respectively) were recruited in the study. All participants were interviewed for 8 weeks, using the 17-item Hamilton Depression Rating Scale (HAMD-17) and the Young Mania Rating Scale(YMRS). The primary dependent measure was the previously validated THINC-it tool, followed by psychometric analysis.ResultsRepeated measures of the THINC-it tool at baseline, one-week, and eight-week periods were conducted after controlling for age, gender, and education effects. Results from the general linear model revealed no significant time differences in variances(P > 0.05). Similarly, adjusting for confounding factors (age, gender, education, and HAMD-17 scores), results from the longitudinal analysis showed that there were no significant differences in cognitive impairment over time(P > 0.05). However, we found significant differences between BD-D and Healthy Control(HC) groups with regards to Spotter, Codebreaker, Trails, Perceived Deficits Questionnaire for Depression-5-items(PDQ-5-D), and THINC-it Total composite(P < 0.05), but not in Symbol Check (p = 0.191).ConclusionThese findings indicate that the THINC-it tool effectively detects sensitivity to change in groups and maintains stability at times, indicating that it is a feasible and reliable instrument for evaluating cognitive dysfunction in Chinese patients with bipolar depression.

Spectrum of Cognitive Impairment in Patients with Multiple Sclerosis

Introduction. Cognitive impairment (CI) is a common manifestation of multiple sclerosis (MS), which significantly affects patients’ daily life and professional activity. Despite the development of methods to screen MS patients for CI, data on its prevalence in the Russian population are still lacking. Aim: to comprehensively assess cognitive functions in patients with different types of MS. Materials and methods. The study included MS patients who did not have any other possible causes of CI and no diseases or conditions that confounded this assessment. CI was determined using the Brief International Cognitive Assessment in Multiple Sclerosis (BICAMS) test battery and the Stroop test as a decrease in the scores below the mean by at least 1.5 standard deviations. CI was subjectively assessed using the Perceived Deficit Questionnaire; fatigue was subjectively assessed using the Modified Fatigue Impact Scale (MFIS). The Mann–Whitney test and Fisher’s exact test were used for comparison, and the Spearman test was used to evaluate correlations. Results. We evaluated 77 MS patients (30 men; age 40 [30; 48] years; 47 with relapsing-remitting MS, 30 with progressive MS). CI incidence was 23.4% in patients with relapsing-remitting MS and 77% in patients with progressive MS, while multi-domain CI was statistically significantly more common in patients with progressive MS. Impairment of processing speed was the most common. Patients with relapsing-remitting MS and CI were statistically significantly older and had longer disease duration than those without CI. There was a statistically significant correlation of subjective CI severity with MFIS scores but not with testing results. Conclusion. CI incidence in MS patients was relatively high with greater severity and involvement of more domains in patients with progressive MS. No correlation was found between subjective and objective CI assessment results, which may suggest that patients underestimated their deficit.

B - 96 Relationships between Self-Reported Cognitive Dysfunction, Functional Activities, and Intraindividual Cognitive Variability in Persons with Multiple Sclerosis (Pwms)

Abstract Objective To examine the relationships between intraindividual cognitive variability (IIV) and self-reported cognitive and functional difficulties in persons with multiple sclerosis (pwMS). We hypothesized higher perceived cognitive and functional difficulties would be associated with higher IIV. Method Participants (n = 35) were pwMS from a prospective memory intervention study. During the baseline evaluation, participants completed an objective neuropsychological test battery and a self-report measure of cognitive functioning (Perceived Deficits Questionnaire; PDQ Total). Participants were asked if they had problems in eight different functional areas due to their memory, with the number of endorsed problems summed. Two measures of IIV, an intraindividual standard deviation (ISD) score and maximum discrepancy score (MDS), were created from 11 indices. The relationship between the IIV and PDQ were assessed with individual linear regressions, controlling for demographics and disease-related characteristics, while Spearman correlations examined the associations with the number of reported functional memory problems. Results The PDQ was not significantly associated with either the ISD (b = −0.03, 95% CI: −0.15, 0.10, p = 0.672) or MDS (b = −0.01, 95% CI: −0.51, 0.32, p = 0.645). The overall number of functional memory problems was correlated with both the PDQ (ρ = 0.40, p = 0.018) and ISD (ρ = −0.35, p = 0.039), but not MSD (ρ = −0.22, p = 0.201). Conclusion(s) Perceived cognitive dysfunction was not associated with IIV. However, self-reported functional problems with memory were associated with perceived cognition, as well as one metric of IIV. ISD may better reflect moment to moment fluctuations that lead to difficulties with daily functioning, as opposed to MDS which may reflect underlying variation (e.g., base rates of impairment) in cognitive performance.

Subjective and objective measures of cognitive function are correlated in persons with Post-COVID-19 Condition: a secondary analysis of a Randomized Controlled Trial.

It remains unclear whether subjective and objective measures of cognitive function in Post COVID-19 Condition (PCC) are correlated. The extent of correlation has mechanistic and clinical implications. This post-hoc analysis of a randomized, double-blind, placebo-controlled clinical trial contains baseline data of subjective and objective measures of cognition in a rigorously characterized cohort living with PCC. Herein, we evaluated the association between subjective and objective condition function, as measured by the Perceived Deficits Questionnaire, 20-item (PDQ-20) and the Digit Symbol Substitution Test (DSST) and Trails Making Test (TMT)-A/B, respectively. A total of 152 participants comprised the baseline sample. Due to missing data, our statistical analyses included 150 for self-reported PDQ-20, 147 individuals for combined DSST-measured cognitive function (composite z-score of the Pen/Paper plus Online CogState Version, NcombinedDSST), 71 for in-person DSST-measured cognitive function (Pen/Paper Version), 70 for TMT-A-measured cognitive function, and 70 for TMT-B-measured cognitive function. After adjusting for age, sex, and education, PDQ-20 was significantly correlated with pen-and-paper DSST (β = -0.003, p = 0.002) and TMT-B (β = 0.003, p = 0.008) scores, but not with TMT-A scores (β = -0.001, p = 0.751). Overall, a statistically significant correlation was observed between subjective and objective cognitive functions. Clinicians providing care for individuals with PCC who have subjective cognitive function complaints may consider taking a measurement-based approach to cognition at the point of care that focuses exclusively on patient-reported measures.

Outcome clusters and their stability over 1 year in patients with SLE: self-reported and performance-based cognitive function, disease activity, mood and health-related quality of life

ObjectiveTo determine if self-reported fatigue, anxiety, depression, cognitive difficulties, health-related quality of life, disease activity scores and neuropsychological battery (NB) cluster into distinct groups in patients with SLE based on...

Effectiveness of vortioxetine in elderly patients with major depressive disorder in real-world clinical practice: Results from the RELIEVE study.

Data demonstrating the real-world, long-term effectiveness of vortioxetine in elderly patients with major depressive disorder (MDD) are clinically useful to confirm findings from randomized trials. RELIEVE was a multinational, 24-week, observational, prospective study in outpatients with MDD initiating vortioxetine treatment in routine care settings (NCT03555136). Here, we report data from a subgroup of 130 patients aged ⩾ 65 years. The primary study outcome was changed from baseline in patient functioning assessed using the Sheehan Disability Scale (SDS). Other clinical outcomes included depression severity (Patient Health Questionnaire-9 [PHQ-9] and Clinical Global Impressions-Severity [CGI-S]), cognitive performance (Digit Symbol Substitution Test [DSST]) and symptoms (Perceived Deficits Questionnaire - Depression-5 item [PDQ-D-5]), and health-related quality of life (HRQoL) (EuroQoL 5 Dimensions 5 Levels [EQ-5D-5L]). Clinically meaningful and statistically significant improvements in patient functioning, depressive symptoms, cognitive function, and HRQoL were observed at week 24. Least squares mean SDS, PHQ-9, CGI-S, PDQ-D-5, DSST, and EQ-5D-5L scores improved from baseline by 6.5, 5.7, 1.2, 3.2, 4.4, and 0.11 points, respectively (p < 0.01 for all). Adverse events were observed in 23.1% of patients. Consistent with previous clinical studies of vortioxetine, this study supports the effectiveness and safety of vortioxetine in treating elderly patients with MDD in a real-world setting over a 6-month period. Patients showed clinically relevant and sustained improvements in psychosocial functioning, depressive symptoms, and cognitive function after receiving vortioxetine, which was generally well tolerated. Main study limitations include the open-label study design and lack of a placebo or comparator group.

Impact of trazodone once-a-day on quality of life and functional recovery in adults with major depressive disorder: A prospective, observational study.

Health-related quality of life (HRQL) is an important goal for patients with major depressive disorder (MDD), but whether antidepressants improve HRQL in these patients is unclear. Here, we describe the real-world effects of trazodone once-a-day (TzOAD) and selective serotonin reuptake inhibitor (SSRI) treatments on HRQL and functioning in adults with MDD. This 8-week prospective, observational, open-label, multicenter study was conducted in adults with moderate or severe MDD for whom TzOAD or SSRI were prescribed as monotherapy. The primary outcome was life enjoyment and satisfaction assessed via the patient-reported Quality-of-Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF) from baseline to week 8. Secondary outcomes included change in Q-LES-Q-SF from baseline to weeks 1 and 2; severity of depressive symptoms using the Montgomery Åsberg Depression Rating Scale (MADRS) and sleep disturbance via the PROMIS SF-SD 8b questionnaire at weeks 1, 2, and 8; and overall functioning via the Sheehan Disability Scale (SDS), hedonic capacity using the Snaith-Hamilton Pleasure Scale (SHAPS), and cognitive dysfunction using the Perceived Deficits Questionnaire (PDQ-5) at baseline and week 8. The study included 208 adults with MDD (mean [SD] age=50.2 [14.3] years; 68.6% female; 98.4% White). Life enjoyment and satisfaction improved from baseline to week 8 for both treatment groups: Q-LES-Q-SF mean (SD) scores were 27.5 (20.4) for the SSRI group and 39.0 (22.1) for the TzOAD group. Depressive symptoms and sleep disturbances also reduced from baseline to week 8: MADRS (SSRI, -15.7 [8.3]; TzOAD, -21.0 [9.8]); PROMIS SF-SD 8b (SSRI, -9.9 [12.6]; TzOAD, -22.0 [12.6]). Mean change scores in Q-LES-Q-SF, MADRS, and PROMIS SF-SD 8b improved as early as week 1 in both groups. Mean scores also improved from baseline to week 8 on SDS (SSRI, -9.2 [7.4]; TzOAD, -14.3 [7.5]), SHAPS (SSRI, -6.6 [4.3]; TzOAD, -8.3 [4.4]), and PDQ-5 (SSRI, -5.8 [4.5]; TzOAD, -7.7 [5.0]). In adults with MDD who received TzOAD or SSRIs, overall and individual HQRL domains improved rapidly and in parallel with improvements in depressive symptoms, with a slightly greater improvement observed in the TzOAD group.

Correlation between cancer-related cognitive impairment and resting cerebral glucose metabolism in patients with ovarian cancer

BackgroundAn increasing number of research have applied neuroimaging techniques to explore the potential neurobiological mechanism of Cancer-related cognitive impairment (CRCI). PurposeTo explore the correlation between resting brain glucose metabolism and CRCI using 18F-FDG PET/CT in ovarian cancer (OC) patients. MethodsFrom December 2021 to March 2022, 38 patients with OC were selected as the study group, and 38 healthy women of the same age (±1 year) who underwent routine physical examination using PET/CT were selected as the control group. Patients received further assessment with the Montreal Cognitive Assessment Scale (MoCA) and Perceived Deficit Questionnaire (PDQ). Independent sample t-test and Spearman correlation were conducted for data analysis. ResultsThe resting brain glucose metabolism in the OC group was significantly lower than in the healthy controls. 60.52 % patients had neuropsychological impairment and retrospective memory were the most serious perceived cognitive impairments. The resting brain glucose metabolism in OC patients did not significantly correlate with neuropsychological performance but had significant positive correlation with subjective cognitive evaluation. DiscussionResting glucose metabolism was low in OC patients and associated with subjective cognitive impairment but not objective neuropsychological test results. 18F-FDG PET/CT can be used to evaluate brain function in OC patients and provide reliable imaging indicators for early recognition of and intervention for changes in cognitive function.

Barriers and strategies to medication adherence amongst people with multiple sclerosis and cognitive problems

BackgroundAdherence to disease-modifying treatment (DMT) amongst people with multiple sclerosis (MS) varies greatly. Although research often identifies 'forgetting' as a reason for poor adherence, few studies have considered how cognitive problems impact adherence. ObjectivesTo investigate prevalence of and barriers to adherence, including for people with MS-related cognitive problems, and to identify adherence-related strategies. MethodsRecruited via the UK MS Register and MS Society groups, participants completed a Medication Adherence Questionnaire and the Perceived Deficits Questionnaire. A subset were interviewed. Results: Of 257 participants, 94 % reported being adherent, although 59 % missed ≥1 dose, and 25 % reported cognitive problems. Adherence was lower amongst those with cognitive problems, who experienced more barriers: memory problems; negative feelings about taking medication; and not wanting medication to interfere with activities. Such barriers, along with mood, cognition, and method of DMT administration, explained 17 % of variance in adherence, with intravenous treatment a significant predictor. Cognitive problems explained a unique proportion of variance; however, was non-significant when anxiety was factored in. Interviews highlighted how anxiety about side-effects and injections, and difficulties accepting the diagnosis, hindered use of reminders. ConclusionInterventions for cognition and mood problems, minimising treatment burden and supporting adjustment to diagnosis, may improve adherence.

Improving prospective memory in persons with multiple sclerosis via telehealth: A randomized feasibility study

BackgroundPersons with multiple sclerosis (PwMS) can experience deficits in prospective memory (PM) or “remembering to remember,” which are associated with functional difficulties. However, no cognitive rehabilitation intervention has specifically addressed improving PM in PwMS. The Telehealth PM Intervention (TPMI) provides a novel combination of two strategies—visual imagery and implementation intentions—that have each been beneficial in other populations. This study aimed to evaluate the feasibility of TPMI and its preliminary efficacy, which could be used to inform future trials. MethodsParticipants (n = 35) were PwMS who were pre-screened and endorsed experiencing problems “remembering places they have to be” and “things they have to do.” After completing a baseline evaluation, which included objective (Memory for Intentions Test; MIST) and subjective (Perceived Deficits Questionnaire; PDQ-PM) measures of PM, participants were randomized to either the active treatment (TPMI; n = 17) or active control group (Control; n = 18). TPMI was offered through remote one-on-one sessions twice a week over a four-week period. Participants were asked about treatment credibility and expectancy during the first session. The MIST and PDQ-PM were repeated at post-treatment, where treatment satisfaction was also captured. Mann-Whitney U and chi-square tests were used to examine the feasibility measures, while repeated measures ANOVAs were used to examine changes in the PM outcomes. ResultsA total of 88.2 % of the TPMI group completed all eight sessions, with moderate-to-high (≥7 out of 10) treatment credibility/expectancy and satisfaction reported by 93.3 % and 86.7 %, respectively. While there were no significant effects on overall PM, the TPMI group had an improvement in objective time-based PM after adjusting for baseline differences (F(1,29) = 4.61, p = 0.040; d = 0.80). Furthermore, the TPMI group had a significant reduction in the number of time-based loss of content errors compared to the Control group, which remained significant after covariate adjustment (F(1,25) = 4.29, p = 0.049; d = 0.83). ConclusionsTPMI is a feasible intervention, with high completion rates and moderate-to-high treatment ratings, that can be delivered remotely. Early evidence shows its potential benefit for improving time-based PM, a particular concern for PwMS, which should be further evaluated in a larger clinical trial.

Validation of the Cognitive Assessment Instrument for Obsessions and Compulsions (CAIOC-13) in an Indian Sample

Background: Brief self-report measures of cognition are advantageous for flagging significant cognitive dysfunction without extensive neuropsychological assessments. The Cognitive Assessment Instrument for Obsessions and Compulsions (CAIOC-13) is a recently developed self-report that assesses everyday cognitive dysfunction in obsessive-compulsive disorder (OCD), for example, difficulties with reading, slowness, and decision-making. This study was undertaken to validate the CAIOC-13 in an Indian sample of OCD. Material and Methods: 75 subjects with OCD and 81 non-clinical controls completed CAIOC-13, Perceived Deficits Questionnaire (PDQ), and Dysfunctional Attitude Scale-Short Form (DAS-SF1). Convergent and divergent validity with PDQ and DAS-SF1 were established with Pearson’s correlation; the Receiver Operating Characteristic (ROC) curve was used to analyze discriminant validity; and factorial structure was evaluated using the principal component analysis (PCA). Results: CAIOC-13 scores showed a strong significant correlation ( r = 0.56; p &lt; .001) with PDQ and a moderate correlation with DAS-SF1 scores ( r = 0.33; p = .003). CAIOC-13 could accurately discriminate between OCD and controls (area under curve = 0.92). PCA revealed strong loading on a single component. Conclusion: CAIOC-13 is a valid tool for briefly assessing OCD-related cognitive dysfunction in Indian samples. Future studies may examine the correlation of CAIOC-13 with standardized neuropsychological assessments.

Association Between Improved Serum Fatty Acid Profiles and Cognitive Function During a Dietary Intervention Trial in Relapsing-Remitting Multiple Sclerosis.

Cognitive impairment is a common multiple sclerosis (MS)-related symptom that impacts quality of life (QOL). Diet interventions are shown to be beneficial in managing QOL, and the intake of essential fatty acids is linked with improved cognitive function. However, the effect of diets on serum fatty acid profiles and cognitive function is unknown. A previous randomized, parallel-arm trial recruited participants with relapsing-remitting MS (N = 77). Study visits included 4 time points: run-in, baseline, 12 weeks, and 24 weeks. During the run-in phase, participants followed their usual diet and were then randomly assigned to either a modified paleolithic (Wahls) or a low saturated fat (Swank) diet at baseline. Assessments at study visits included cognitive function assessed by Symbol Digit Modalities Test-Oral (SDMT-O) and Perceived Deficits Questionnaire (PDQ), and serum fatty acids, including eicosapentaenoic (EPA), docosahexaenoic (DHA), and arachidonic (ARA) acids. Both groups had significant improvements in all serum fatty acids (P < .01), except for ARA, as well as SDMT-O at 24-weeks (P < .05), total PDQ at 12 and 24 weeks (P < .01) compared with baseline values. The 12-week changes in ω-3 (EPA + DHA) index and EPA serum fatty acids were associated with SDMT-O changes (P ≤ .05); however, the changes in fatty acid levels did not mediate the effect of the diets on SDMT-O or PDQ (P > .05). Both diets led to improvements in serum fatty acid profiles and cognitive function, with associations between the 12-week ω-3 (EPA + DHA) index and EPA changes with SDMT-O.

A retrospective chart review to assess the impact of alpha-guided transcranial magnetic stimulation on symptoms of PTSD and depression in active-duty special operations service members.

Special Operations Forces service members (SOF) are regularly exposed to traumatic and concussive events, increasing the prevalence of symptoms of post-traumatic stress disorder (PTSD) and depression, shortening potential years of service. This retrospective chart review presents preliminary data on a Human Performance Optimization (HPO) program that provided an average of 30 sessions of individualized alpha frequency repetitive transcranial magnetic stimulation (α-rTMS) to active-duty SOF as to reduce symptoms of PTSD and depression following traumatic brain injury. Scores from the PTSD Checklist for DSM-5, PROMIS Depression short form and Perceived Deficits Questionnaire (PDQ) were reviewed. Significant reductions were noted after the HPO program in all clinical scales with an average 37% decrease in PCL-5 (p<.01), 11.3% reduction in PROMIS depression T-scores (p<.01), and 45.5% reduction in PDQ scales by session 30 (p<.01), with side effects matching those commonly reported in rTMS. Importantly, the average PCL-5 score decreased from 42.9 to 27 by end of the treatment program, which is below the clinical threshold of 33 for presence of PTSD. For those with depression symptoms scores greater than cut off clinical thresholds at baseline, 46% resolved following treatment. This data provides preliminary support for safe application of α-rTMS for symptom reduction in active-duty special operations military personnel.

PREVIDA- IMPACT OF VORTIOXETINE ON MAJOR DEPRESSIVE DISORDER AND PERCEIVED COGNITIVE DYSFUNCTION: A MULTICENTER STUDY

Objective: To find out how common cognitive impairment is in people with major depressive disorder (MDD) and assess how well vortioxetine works for treating both cognitive dysfunction and depressive symptoms. Study Design: Multi-centred, Cross-sectional, prospective follow up design Place &amp; Duration of Study: The research took place over the course of 12 weeks at 16 different psychiatric outpatient clinics throughout Pakistan, from September 2020 to November 2020. Method: The study included 498 individuals with serious depressive disorder diagnoses. The degree of depression symptoms and cognitive impairment was assessed. Psychiatrists gave trial participants vortioxetine after completing the Clinical Global Impression-Severity scale (CGI-S), the Patient Health Questionnaire-9 (PHQ-9), and the Perceived Deficits Questionnaire (PDQ). The variables were reassessed one week (+/- 3 days), one month (+/- 7 days), and three months (+/- 14 days) after the treatment began. Results: After completing a 12-week course of therapy with vortioxetine, mean PHQ 9 and PDQ scores of MDD individuals showed significant improvements. This indicates that vortioxetine is effective in reducing depression symptoms as well as cognitive impairments in MDD patients. A strong connection was seen between PHQ-9 and PDQ scores, indicating a direct relationship between cognitive impairment and depressed symptoms. Conclusions: The results of the research demonstrate how well vortioxetine works to treat cognitive impairments in MDD patients while also reducing depressed symptoms. These findings demonstrate the possibility of vortioxetine as a beneficial therapeutic option for those with MDD diagnoses who also have cognitive impairment. Additional investigation is required to validate these findings and assess their suitability for other demographics.

Psychometric Properties of the Korean Version of THINC-integrated Tool (THINC-it-K): A Tool for Screening Assessment of Cognitive Function in Patients with Major Depressive Disorder.

: The present study was performed to investigate the validity and reliability of the Korean version of the THINC-it tool (THINC-it-K) in adult patients with major depressive disorder (MDD). : Subjects aged 19-65 years with recurrent MDD experiencing moderate to severe major depressive episode (n = 44) were evaluated and compared to age and sex matched healthy controls (n = 44). Subjects completed the THINC-it-K which includes variants of the Identification Task (IDN) using Choice Reaction Time, One-Back Test, Digit Symbol Substitution Test, Trail Making Test-Part B, and the Perceived Deficits Questionnaire for Depression-5-item (PDQ-5-D). : A total of 75.0% of patients with MDD exhibited cognitive performance 1 standard deviation or below. The differences in Spotter (p = 0.001), Codebreaker (p = 0.001), PDQ-5-D (p ＜ 0.001) and objective THINC-it-K composite score (p = 0.002) were significant between the two groups. Concurrent validity of the THINC-it-K based on a calculated composite score was good (r = 0.856, p ＜ 0.001), and ranges for each component tests were from 0.076 (IDN) to 0.928 (PDQ-5-D). : The THINC-it-K exhibits good reliability and validity in adults with MDD. It could be a useful tool for the measurement of cognitive deficits in persons with MDD and should be implemented in clinical practice.

Impact of fatigue as the primary determinant of functional limitations among patients with post-COVID-19 syndrome: a cross-sectional observational study

ObjectivesTo describe self-reported characteristics and symptoms of treatment-seeking patients with post-COVID-19 syndrome (PCS). To assess the impact of symptoms on health-related quality of life (HRQoL) and patients’ ability to work...

Objective and subjective cognition in survivors of COVID-19 one year after ICU discharge: the role of demographic, clinical, and emotional factors

BackgroundIntensive Care Unit (ICU) COVID-19 survivors may present long-term cognitive and emotional difficulties after hospital discharge. This study aims to characterize the neuropsychological dysfunction of COVID-19 survivors 12 months after ICU discharge, and to study whether the use of a measure of perceived cognitive deficit allows the detection of objective cognitive impairment. We also explore the relationship between demographic, clinical and emotional factors, and both objective and subjective cognitive deficits.MethodsCritically ill COVID-19 survivors from two medical ICUs underwent cognitive and emotional assessment one year after discharge. The perception of cognitive deficit and emotional state was screened through self-rated questionnaires (Perceived Deficits Questionnaire, Hospital Anxiety and Depression Scale and Davidson Trauma Scale), and a comprehensive neuropsychological evaluation was carried out. Demographic and clinical data from ICU admission were collected retrospectively.ResultsOut of eighty participants included in the final analysis, 31.3% were women, 61.3% received mechanical ventilation and the median age of patients was 60.73 years. Objective cognitive impairment was observed in 30% of COVID-19 survivors. The worst performance was detected in executive functions, processing speed and recognition memory. Almost one in three patients manifested cognitive complaints, and 22.5%, 26.3% and 27.5% reported anxiety, depression and post-traumatic stress disorder (PTSD) symptoms, respectively. No significant differences were found in the perception of cognitive deficit between patients with and without objective cognitive impairment. Gender and PTSD symptomatology were significantly associated with perceived cognitive deficit, and cognitive reserve with objective cognitive impairment.ConclusionsOne-third of COVID-19 survivors suffered objective cognitive impairment with a frontal-subcortical dysfunction 12 months after ICU discharge. Emotional disturbances and perceived cognitive deficits were common. Female gender and PTSD symptoms emerged as predictive factors for perceiving worse cognitive performance. Cognitive reserve emerged as a protective factor for objective cognitive functioning.Trial registration: ClinicalTrials.gov Identifier: NCT04422444; June 9, 2021.

Perceived Cognitive Deficits in Patients With Symptomatic SARS-CoV-2 and Their Association With Post–COVID-19 Condition

Neuropsychiatric symptoms are common in acute SARS-CoV-2 infection and in post-COVID-19 condition (PCC; colloquially known as long COVID), but the association between early presenting neuropsychiatric symptoms and PCC is unknown. To describe the characteristics of patients with perceived cognitive deficits within the first 4 weeks of SARS-CoV-2 infection and the association of those deficits with PCC symptoms. This prospective cohort study was conducted from April 2020 to February 2021, with follow-up of 60 to 90 days. The cohort consisted of adults enrolled in the University of California, Los Angeles, SARS-CoV-2 Ambulatory Program who had a laboratory-confirmed symptomatic SARS-CoV-2 infection and were either hospitalized in a University of California, Los Angeles, hospital or one of 20 local health care facilities, or were outpatients referred by a primary care clinician. Data analysis was performed from March 2022 to February 2023. Laboratory-confirmed SARS-CoV-2 infection. Patients responded to surveys that included questions about perceived cognitive deficits modified from the Perceived Deficits Questionnaire, Fifth Edition, (ie, trouble being organized, trouble concentrating, and forgetfulness) and symptoms of PCC at 30, 60, and 90 days after hospital discharge or initial laboratory-confirmed infection of SARS-CoV-2. Perceived cognitive deficits were scored on a scale from 0 to 4. Development of PCC was determined by patient self-report of persistent symptoms 60 or 90 days after initial SARS-CoV-2 infection or hospital discharge. Of 1296 patients enrolled in the program, 766 (59.1%) (mean [SD] age, 60.0 [16.7] years; 399 men [52.1%]; 317 Hispanic/Latinx patients [41.4%]) completed the perceived cognitive deficit items at 30 days after hospital discharge or outpatient diagnosis. Of the 766 patients, 276 (36.1%) perceived a cognitive deficit, with 164 (21.4%) having a mean score of greater than 0 to 1.5 and 112 patients (14.6 %) having a mean score greater than 1.5. Prior cognitive difficulties (odds ratio [OR], 1.46; 95% CI, 1.16-1.83) and diagnosis of depressive disorder (OR, 1.51; 95% CI, 1.23-1.86) were associated with report of a perceived cognitive deficit. Patients reporting perceived cognitive deficits in the first 4 weeks of SARS-CoV-2 infection were more likely to report symptoms of PCC than those without perceived cognitive deficits (118 of 276 patients [42.8%] vs 105 of 490 patients [21.4%]; χ21, 38.9; P < .001). Adjusting for demographic and clinical factors, perceived cognitive deficits in the first 4 weeks of SARS-CoV-2 were associated with PCC symptoms (patients with a cognitive deficit score of >0 to 1.5: OR, 2.42; 95% CI, 1.62-3.60; patients with cognitive deficit score >1.5: OR, 2.97; 95% CI, 1.86-4.75) compared to patients who reported no perceived cognitive deficits. These findings suggest that patient-reported perceived cognitive deficits in the first 4 weeks of SARS-CoV-2 infection are associated with PCC symptoms and that there may be an affective component to PCC in some patients. The underlying reasons for PCC merit additional exploration.