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Harsi ELMEL, Benksim A, Cherkaoui M. Cognitive complaints in older adults in primary care and associated factors. Dement Neuropsychol 2023; 17:e20220096. [PMID: 37261254 PMCID: PMC10229085 DOI: 10.1590/1980-5764-dn-2022-0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 02/11/2023] [Accepted: 02/27/2023] [Indexed: 06/02/2023] Open
Abstract
Cognitive complaints are common in older people. They can progress into a more severe cognitive decline and then deterioration of quality of life. They are associated with several factors. Objective This study aimed to determine the factors associated with cognitive complaints in older adults in the city of Marrakech, Morocco. Methods This study was conducted between March and June 2022 among 281 people aged 50 years and older who attended primary health care centers in the city of Marrakech. Cognitive complaints were measured using the McNair-Kahn scale. Data on sociodemographic and clinical characteristics were collected through interviews with the participants and consultation of their medical records. Analysis was done using Statistical Package for Social Sciences (SPSS) version 25, Ink software. Results Of the total participants, 51.6% had cognitive complaints. Multivariate analysis showed that people aged 75 years and over had a sevenfold higher risk of cognitive complaints than people aged 50-64 years (p=0.033; OR=7.64; 95%CI 1.17-49.72), and that illiteracy (p=0.004; OR=3.39; 95%CI 1.48-7.76), cardiovascular disease (p=0.018; OR=4.30; 95%CI 1.29-14.32), diabetes (p=0.001; OR=3.14; 95%CI 1.64-6.04), visual impairment (p=0.017; OR=2.22; 95%CI 1.15-4.19), depression (p= 0.027; OR=2.36; 95%CI 1.10-5.05) and sleepiness (p=0.034; OR=1.96; 95%CI 1.05-3.66) are associated variables. Conclusions Cognitive complaints are frequent in older adults and are associated with several sociodemographic and health factors. Some measures could help maintain stable memory performance in old age and prevent severe cognitive declines, such as regular follow-up of at-risk individuals, and cognitive, physical and leisure activities.
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Affiliation(s)
- EL Mahjoub EL Harsi
- Cadi Ayyad University, Faculty of Sciences Semlalia, Laboratory of Pharmacology, Neurobiology, Anthropobiology and Environment, Marrakech, Morocco
- Regional Health Directorate, Higher Institute of Nursing Professions and Health Techniques, Nursing Care Department, Marrakech, Morocco
| | - Abdelhafid Benksim
- Cadi Ayyad University, Faculty of Sciences Semlalia, Laboratory of Pharmacology, Neurobiology, Anthropobiology and Environment, Marrakech, Morocco
- Regional Health Directorate, Higher Institute of Nursing Professions and Health Techniques, Nursing Care Department, Marrakech, Morocco
| | - Mohamed Cherkaoui
- Cadi Ayyad University, Faculty of Sciences Semlalia, Laboratory of Pharmacology, Neurobiology, Anthropobiology and Environment, Marrakech, Morocco
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Ferguson N, Rice S, Gleeson J, Davey CG, Hetrick SE. The experience of young people receiving cognitive behavioural therapy for major depression: A qualitative study. Early Interv Psychiatry 2023; 17:47-56. [PMID: 35347874 PMCID: PMC10946930 DOI: 10.1111/eip.13290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/05/2022] [Accepted: 03/13/2022] [Indexed: 01/21/2023]
Abstract
AIM Major depressive disorder (MDD) has far reaching impacts for young people, their families and society. Cognitive behavioural therapy (CBT) is one of the first-line treatments for young people experiencing MDD; however, there is limited research examining how young people with MDD experience CBT. The aim of this study was to explore their experience and their views of this intervention. METHODS We employed a qualitative research design, with semi-structured interviews and thematic analysis. Eight participants aged between 17 and 24 years who received CBT for MDD in a randomized controlled trial were recruited. RESULTS Five themes were identified: the importance of relationship with clinician; the range of useful components within CBT; the ability for CBT to accommodate different techniques and presenting issues; the importance of checking in with clients during the process of therapy; and the impacts of MDD on therapy. CONCLUSIONS The findings highlight the importance of clinicians having a youth friendly and collaborative approach that allows a modular delivery of a range of CBT techniques to suit the client's presenting issue and formulation. There is a need to continually check how young people are responding to interventions, and to be aware of potential cognitive deficits and adjust therapy accordingly. This is a small study that provides insight into how young people with MDD experience CBT and avenues to explore for tailoring provision of CBT to enhance the therapeutic experience for this population.
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Affiliation(s)
| | - Simon Rice
- OrygenUniversity of MelbourneParkvilleVictoriaAustralia
- Centre for Youth Mental HealthThe University of MelbourneParkvilleVictoriaAustralia
| | - John Gleeson
- Healthy Brain and Mind Research Centre, School of Behavioural and Health SciencesAustralian Catholic UniversityMelbourneVictoriaAustralia
| | - Christopher G. Davey
- OrygenUniversity of MelbourneParkvilleVictoriaAustralia
- Centre for Youth Mental HealthThe University of MelbourneParkvilleVictoriaAustralia
- Healthy Brain and Mind Research Centre, School of Behavioural and Health SciencesAustralian Catholic UniversityMelbourneVictoriaAustralia
| | - Sarah E. Hetrick
- OrygenUniversity of MelbourneParkvilleVictoriaAustralia
- Centre for Youth Mental HealthThe University of MelbourneParkvilleVictoriaAustralia
- Department of Psychological MedicineUniversity of AucklandAucklandNew Zealand
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Lau SCL, Connor LT, Baum CM. Subjective and objective assessments are associated for physical function but not cognitive function in community-dwelling stroke survivors. Disabil Rehabil 2022; 44:8349-8356. [PMID: 34904503 DOI: 10.1080/09638288.2021.2012845] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE To investigate the relation between subjectively and objectively assessed cognitive and physical functioning among community-dwelling stroke survivors, and to examine the association of stroke severity with subjectively and objectively assessed cognitive and physical impairments. MATERIALS AND METHODS Secondary data analysis was conducted with 127 community-dwelling stroke survivors. For cognitive functioning, objective measures included the NIH Toolbox Cognition Battery and the Executive Function Performance Test; subjective measures included the Quality of Life in Neurological Disorders Applied Cognition. Objective and subjective physical functioning was measured by the NIH Toolbox 2-Minute Walk Test and the Patient-Reported Outcomes Measurement Information System Physical Function, respectively. RESULTS A positive correlation was observed between subjective and objective physical functioning, whereas the correlation between subjective and objective cognitive functioning was nonsignificant. Stroke severity was associated with objective cognitive impairment and objective and subjective physical impairment, but not subjective cognitive impairment. CONCLUSIONS The lack of association between objective and subjective cognitive functioning challenges the conventional assumption that perceived functioning reflects actual performance. We recommend using both objective and subjective measures to accurately identify cognitive and physical impairment following stroke.Implications for RehabilitationSubjective cognitive functioning is not associated with objective cognitive functioning, suggesting that solely relying on stroke patients' reports is inadequate and may inaccurately estimate patients' actual deficits.Both objective and subjective measures should be used to accurately identify cognitive and physical impairment following stroke.Practitioners should be cognizant of stroke patients' behavioral signs associated with underlying cognitive problems that warrant further evaluation.
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Affiliation(s)
- Stephen C L Lau
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Lisa Tabor Connor
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Carolyn M Baum
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.,Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
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Daglas-Georgiou R, Bryce S, Smith G, Kaur M, Cheng N, De Rozario M, Wood SJ, Allott K. Treatments for objective and subjective cognitive functioning in young people with depression: Systematic review of current evidence. Early Interv Psychiatry 2022; 16:1057-1074. [PMID: 34825492 DOI: 10.1111/eip.13248] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 08/31/2021] [Accepted: 11/07/2021] [Indexed: 11/26/2022]
Abstract
AIM Cognitive deficits are recognized features of depressive disorders in youth aged 12-25. These deficits are distressing, predict functional impairment and limit the effectiveness of psychological therapies. Cognitive enhancement using behavioural, biochemical or physical treatments may be useful in young people with depression, but studies have not been synthesized. The aim was to systematically review the evidence for treatments for objective and subjective cognitive functioning, and their acceptability and functional outcomes in people aged 12-25 with depression. METHOD Three electronic databases were searched for articles using pre-specified criteria. Pharmacological treatments were not eligible. Risk of bias was rated using the Cochrane Collaboration's revised risk-of-bias tool. Dual full-text article screening, data extraction and quality ratings were completed. RESULTS Twelve studies were included for review (median participant age: 20.39 years), five of which were randomized-controlled trials (RCTs). Sample sizes were generally small (median = 23; range: 9-46). Eight studies investigated behavioural treatments including aerobic exercise, cognitive training and education or strategy-based methods. Four studies examined repetitive transcranial magnetic brain stimulation (rTMS). Most behavioural treatments revealed preliminary evidence of improved cognitive function in youth depression. Consent rates were greatest for exercise- and education-based approaches, which may indicate higher acceptability levels. Findings from rTMS trials were mixed, with only half showing cognitive improvement. Functional outcomes were reported by three behavioural treatment trials and one rTMS trial, with functional improvement reported only in the former. Some concern of risk of bias was found in each RCT. CONCLUSION Behavioural treatments, such as exercise, cognitive training and education/strategy-focused techniques, show encouraging results and appear to be acceptable methods of addressing cognitive deficits in youth depression based on participation rates. Brain stimulation and biochemical treatments (e.g., nutrient-based treatment) require further investigation.
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Affiliation(s)
- Rothanthi Daglas-Georgiou
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Shayden Bryce
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Gabriel Smith
- Faculty of Science, The University of Melbourne, Parkville, Victoria, Australia
| | - Manreena Kaur
- Neuroscience Research Australia (NeuRA), Randwick, New South Wales, Australia.,School of Psychiatry, University of New South Wales, Kensington, Australia.,Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Department of Psychiatry, Monash University, Melbourne, Australia
| | - Nicholas Cheng
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Magdalene De Rozario
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Stephen J Wood
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.,School of Psychology, University of Birmingham, Edgbaston, UK
| | - Kelly Allott
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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Allott K, Gao CX, Fisher C, Hetrick SE, Filia KM, Menssink JM, Herrman HE, Rickwood DJ, Parker AG, McGorry PD, Cotton SM. The Neuropsychological Symptoms Self-Report: psychometric properties in an adolescent and young adult mental health cohort. Child Adolesc Ment Health 2022; 27:111-121. [PMID: 33913237 DOI: 10.1111/camh.12473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/26/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Subjective cognitive symptoms are common in young people receiving mental health treatment and are associated with poorer outcomes. The aim of this study was to determine the psychometric properties of the Neuropsychological Symptoms Self-Report (NSSR), an eight-item measure recently developed to provide a snapshot of young people's perceived change in cognitive functioning in relation to mental health treatment. METHOD The sample included 633 youth aged 12-25 years (Mage = 18.2, 66.5% female, 88.6% Australian-born) who had sought mental health treatment in primary headspace services. At three-month follow-up, participants completed the NSSR and self-report measures of depression and anxiety. RESULTS Excellent internal consistency was found: Cronbach's alpha = 0.93. The NSSR had negative correlations with self-reported anxiety (r = -.33, p < .001) and depression (r = -.48, p < .001) symptoms, suggesting a link with affective symptoms, but still independence of constructs. Exploratory and confirmatory factor analyses supported a single-factor model. Item response theory (IRT) analysis suggested good model fit (homogeneity, data integrity, scalability, local independence and monotonicity) for all items. There was some evidence of measurement noninvariance (for item thresholds) by sex and age, but not diagnosis. IRT models also supported briefer six- and three-item versions of the NSSR. CONCLUSION In busy clinical practice, clinicians need a rapid and reliable method for determining whether cognitive symptoms are of concern and in need of further assessment and treatment. Study findings support the NSSR as a brief, psychometrically sound measure for assessing subjective cognitive functioning in adolescents and young adults receiving mental health treatment.
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Affiliation(s)
- Kelly Allott
- Orygen, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
| | - Caroline X Gao
- Orygen, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia.,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Caroline Fisher
- Department of Psychology, Royal Melbourne Hospital, Melbourne Health, Parkville, Vic., Australia.,The Melbourne Clinic, Richmond, Vic., Australia
| | - Sarah E Hetrick
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Kate M Filia
- Orygen, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
| | - Jana M Menssink
- Orygen, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
| | - Helen E Herrman
- Orygen, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
| | - Debra J Rickwood
- headspace National Youth Mental Health Foundation, Melbourne, Vic., Australia.,Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Alexandra G Parker
- Orygen, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia.,Institute for Health and Sport, Victoria University, Melbourne, Vic., Australia
| | - Patrick D McGorry
- Orygen, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
| | - Sue M Cotton
- Orygen, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
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Lee SH, Jeon SW, Shin C, Pae CU, Patkar AA, Masand PS, An H, Han C. Acute Efficacy and Safety of Escitalopram Versus Desvenlafaxine and Vortioxetine in the Treatment of Depression With Cognitive Complaint: A Rater-Blinded Randomized Comparative Study. Psychiatry Investig 2022; 19:268-280. [PMID: 35500900 PMCID: PMC9058271 DOI: 10.30773/pi.2021.0368] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/17/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study aimed to compare the efficacy and safety of escitalopram, vortioxetine, and desvenlafaxine for acute treatment of major depressive disorder (MDD) with cognitive complaint (CC). METHODS A total of 129 patients with MDD who also complained of CC were randomized evenly to either escitalopram, vortioxetine, or desvenlafaxine group and underwent a multi-center, six-week, rater-blinded, and head-to-head comparative trial. Differences in depressive symptoms following treatment were measured using the Hamilton Depression Rating Scale (HAMD) and the Montgomery-Åsberg Depression Rating Scale (MADRS). Subjective cognitive function and the presence of adverse events were assessed. RESULTS The three antidepressant treatment groups did not show significant differences in the improvement of depressive symptoms as measured by HAMD and MADRS. Desvenlafaxine treatment was associated with a superior treatment response rate in depressive symptoms compared to vortioxetine or escitalopram treatment. However, no significant differences were found in the remission rate of depressive symptoms. The three antidepressant treatment groups did not show significant differences in the improvement of CC. Adverse profiles of each treatment group were tolerable, with no significant differences. CONCLUSION In acute antidepressant treatment for MDD with CC, escitalopram, vortioxetine, and desvenlafaxine presented similar efficacy in relief of depressive symptoms; however, desvenlafaxine was associated with a superior treatment. Further studies are needed to confirm these results by investigating the therapeutic efficacy and safety profile of long-term antidepressant treatment of MDD with CC (Clinical Trial Registry, http://cris.nih.go.kr/cris/en/: KCT0002173).
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Affiliation(s)
- Seung-Hoon Lee
- Department of Psychiatry, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Sang Won Jeon
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Cheolmin Shin
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Chi-Un Pae
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ashwin A Patkar
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | | | - Hyonggin An
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Changsu Han
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
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Yapici-Eser H, Yalcinay-Inan M, Kucuker MU, Kilciksiz CM, Yilmaz S, Dincer N, Kilic O, Ercan AC, Aydemir O. Subjective cognitive assessments and N-back are not correlated, and they are differentially affected by anxiety and depression. APPLIED NEUROPSYCHOLOGY-ADULT 2021:1-11. [PMID: 34505812 DOI: 10.1080/23279095.2021.1969400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Cognitive function (CF) is a core feature related to all psychiatric disorders. However, self-report scales of CF (SRSC) may not always correlate with CF's objective measures and may have different mediators. Tools to select for evaluating CF in diverse psychiatric populations and their determinants need to be studied. In this study, we aimed to assess the association of SRSC (Perceived Deficit Questionnaire-Depression (PDQ-D), and World Health Organization's Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS) and its inattentiveness subscale) with Letter-N-back as an objective measure of CF, and to analyze their association with psychopathology. Two hundred nine (131 nonclinical, and 78 clinical with a psychiatric diagnosis of ICD10 F31-39 [mood disorders excluding Bipolar I] or F40-F49 [neurotic, stress-related or psychosomatic disorder] categories) participants were evaluated with PDQ-D, ASRS, Beck Depression Inventory (BDI), and Beck's Anxiety Inventory (BAI), and N-back. Both groups' data were included in the analysis. PDQ-D showed a small correlation with N-back scores, whereas ASRS showed no correlation. PDQ-D and ASRS showed a large correlation. Age and BAI scores significantly predicted both PDQ-D and ASRS, whereas the cognitive subscale of BDI predicted PDQ-D, but not ASRS. Only BAI scores predicted N-back results. The mediation model revealed that 2-back scores of N-back task directly affects PDQ-D scores, independent of BDI scores. However, the cognitive subscale of BDI moderated 2-back and PDQ-D association. On the contrary, BAI scores significantly mediated the association of 2-back scores with PDQ-D. The direct effect of 2-back scores in PDQ-D was insignificant in the mediation of BAI scores. Our study validates the discordance between SRSC and an objective measurement of CF. Anxiety may affect both self-report and objective measurement of CF, whereas depressive thought content may lead to higher cognitive dysfunction reports in nondemented participants.
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Affiliation(s)
- Hale Yapici-Eser
- Department of Psychiatry, School of Medicine, Koç University, İstanbul, Turkey.,Research Center for Translational Medicine, Koç University, İstanbul, Turkey
| | | | | | | | - Sezen Yilmaz
- School of Medicine, Koç University, İstanbul, Turkey
| | - Neris Dincer
- School of Medicine, Koç University, İstanbul, Turkey
| | - Ozge Kilic
- Department of Psychiatry, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey
| | | | - Omer Aydemir
- Department of Psychiatry, School of Medicine, Manisa Celal Bayar University, Manisa, Turkey
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Abstract
Cognitive impairment plays a key role in determining the course of illness and functional outcomes in mood disorders. This article summarises and discusses important papers within this thematic series of BJPsych Open that contribute to a greater understanding of the complexity of 'Cognition in Mood Disorders'.
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Affiliation(s)
- Katie M Douglas
- Department of Psychological Medicine, University of Otago, New Zealand
| | - Richard J Porter
- Specialist Mental Health Services, Canterbury District Health Board, New Zealand; and Department of Psychological Medicine, University of Otago, New Zealand
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, UK
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Allott K, Gao C, Hetrick SE, Filia KM, Menssink JM, Fisher C, Hickie IB, Herrman HE, Rickwood DJ, Parker AG, Mcgorry PD, Cotton SM. Subjective cognitive functioning in relation to changes in levels of depression and anxiety in youth over three months of treatment - CORRIGENDUM. BJPsych Open 2020; 6:e110. [PMID: 32924901 PMCID: PMC7576658 DOI: 10.1192/bjo.2020.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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