Treatments for objective and subjective cognitive functioning in young people with depression: Systematic review of current evidence

Participation Preferences in Cognitive Treatments Among Youth With Mental Illness: Findings From the Your Mind, Your Choice Survey

AIM

To explore the cognitive treatment preferences of young people with mental illness.

METHODS

Two-hundred and fourteen people, aged 12-25 years, were surveyed about their treatment priorities. Participants were specifically asked how they might like to receive cognitive treatments and identify factors that might influence their decisions to participate.

RESULTS

Over half of the participants indicated that they would like to receive treatment face-to-face, in a one-on-one setting, with a treatment focus on both deficits and strengths, or without involvement from friends or family when asked about each preference individually. However, only 11% of people wanted all four of these preferences combined. Treatment cost, effectiveness, therapeutic relationships, and accessibility were the most frequently identified factors that could influence perceived decisions to participate.

CONCLUSIONS

The cognitive treatment preferences of young people are variable. Supports focusing on both cognitive strengths and deficits were a novel finding and warrants further attention within existing treatment frameworks.

Social Determinants of Health and Perceived Cognitive Difficulties in High School Students in the United States

OBJECTIVE

The United States Centers for Disease Control and Prevention (CDC) conducted the Adolescent Behavior and Experiences Survey (ABES) to examine disruption and adversity during the COVID-19 pandemic. We examined the association between social determinants of health (SDoH) and cognitive problems attributed to physical or mental health problems among high school students.

METHOD

The ABES was an online survey. Perceived cognitive problems were assessed with the question: "Because of a physical, mental, or emotional problem, do you have serious difficulty concentrating, remembering, or making decisions?" A SDoH index was created by summing endorsements to 12 variables.

RESULTS

Participants were 6,992 students, age 14-18, with 3,294 boys (47%) and 3,698 girls (53%). Many adolescents reported experiencing cognitive problems (i.e., 45%), with girls (56%) more likely to report cognitive difficulties than boys (33%) [χ2(1) = 392.55, p < 0.001]. Having poor mental health was strongly associated with cognitive problems in both girls [81%, χ2(1, 3680) = 650.20, p < 0.001] and boys [67%, χ2(1, 3267) = 418.69, p < 0.001]. There was a positive, linear association between the number of SDoH experienced and reporting cognitive problems. Binary logistic regressions were used to identify predictors of cognitive difficulty for both boys and girls (e.g., being bullied electronically, experiencing food insecurity during the pandemic, being treated unfairly because of their race or ethnicity, and being in a physical fight).

CONCLUSIONS

A strikingly high proportion of adolescents reported experiencing problems with their cognitive functioning. After adjusting for current mental health problems, several SDoH remained associated with adolescents' reported cognitive difficulties, including experiencing racism, bullying, parental job loss, and food insecurity.

Mindfulness enhances cognitive functioning: a meta-analysis of 111 randomized controlled trials

BACKGROUND

Currently no comprehensive meta-analysis of MBI efficacy on global and unique cognitive subdomains exist.

METHOD

Examined the effects of MBIs on global cognition and 15 cognitive subdomains. Inclusion criteria: meditation naïve participants; randomized controlled trial; outcome included one objective or subjective cognitive functioning measure; primary focus was teaching mindfulness skills. Exclusion criteria: inadequate data; one-session ; control condition contained any MBI component. Robust variance estimation and moderator analyses controlling for presence of treatment fidelity were conducted.

RESULTS

One-hundred-and-eleven RCTs (n = 9,538) met eligibility criteria. MBIs had small-to-moderate significant effects on global cognition, executive attention, working memory accuracy, inhibition accuracy, shifting accuracy, sustained attention, and subjective cognitive functioning (vs. waitlist/no-treatment, g = 0.257-0.643; vs. active controls, g = 0.192-0.394). MBIs did not impact executive functioning (EF) latency indices, verbal fluency, processing speed, episodic memory, and cognitive error. Treatment effects were stronger for those with elevated psychiatric symptoms vs. healthy controls, and medical samples, studies with complete-case (vs. intention-to-treat) analysis, face-to-face (vs. self-guided) delivery, and non-standard (vs. standard MBI).

CONCLUSION

MBIs consistently yielded small-to-moderate yet practically meaningful effect sizes on global cognition and six cognitive subdomains that captured accuracy vs. latency-based indices of EF and sustained accuracy.

Perceived cognitive impairment is related to internalizing psychopathology but unrelated to objective cognitive performance among nongeriatric adults presenting for outpatient neuropsychological evaluation

Objective: This study investigated the relationship between perceived cognitive impairment, objective cognitive performance, and intrapersonal variables thought to influence ratings of perceived cognitive impairment. Method: Study sample comprised 194 nongeriatric adults who were seen in a general outpatient neuropsychology clinic for a variety of referral questions. The cognition subscale score from the WHO Disability Assessment Schedule served as the measure of perceived cognitive impairment. Objective cognitive performance was indexed via a composite score derived from a comprehensive neuropsychological battery. Internalizing psychopathology was indexed via a composite score derived from anxiety and depression measures. Medical and neuropsychiatric comorbidities were indexed by the number of different ICD diagnostic categories documented in medical records. Demographics included age, sex, race, and years of education. Results: Objective cognitive performance was unrelated to subjective concerns, explaining <1% of the variance in perceived cognitive impairment ratings. Conversely, internalizing psychopathology was significantly predictive, explaining nearly one-third of the variance in perceived cognitive impairment ratings, even after accounting for test performance, demographics, and number of comorbidities. Internalizing psychopathology was also highly associated with a greater discrepancy between scores on perceived and objective cognitive measures among participants with greater cognitive concerns. Clinically significant somatic symptoms uniquely contributed to the explained variance in perceived cognitive impairment (by ∼13%) when analyzed in a model with internalizing symptoms. Conclusions: These findings suggest that perceived cognitive impairment may be more indicative of the extent of internalizing psychopathology and somatic concerns than cognitive ability.

Efficacy of rTMS for poststroke epilepsy and its effects on patients' cognitive function and depressive status

OBJECTIVE

This study aimed to investigate the efficacy of rTMS in the treatment of poststroke epilepsy and the effect of rTMS on patients' cognitive function and depressive status.

METHODS

One hundred and twenty-one poststroke epilepsy patients with mild cognitive impairment and depressive status admitted to the Department of Neurology of the Second People's Hospital of Nanning from January 1, 2017, to April 31, 2023, were selected and divided into the rTMS treatment group (treated group) and the control group. MMSE scores and HAMD scores were recorded before and after treatment. The frequency of EEG spiky waves recorded before and after treatment within 24 h and the frequency of any clinical seizure form (the number of clinical seizures within 1 month after treatment) and changes in observed indices before and after treatment were calculated. The differences between the data of the two groups were analyzed, to further assess the efficacy of rTMS in the treatment of poststroke epilepsy and the rTMS' effects on cognition and depression.

RESULTS

Compared with drug treatment alone, rTMS significantly decreased clinical seizures and epileptiform discharges after stroke, especially in patients with lesions in the frontal, temporal, and parietal lobes. Compared with drug treatment alone, rTMS treatment can effectively reduce cognitive impairment and mood disorders, such as depression, especially for patients with lesions in the frontal and temporal lobes. The results of this experiment suggest that rTMS treatment does not increase adverse effects.

CONCLUSION

rTMS reduces clinical seizures while improving cognitive impairment and depression in patients with epilepsy. Therefore, we suggest that low-frequency rTMS can be used as an adjunctive treatment for patients with epilepsy and provide some ideas and references for the treatment of epilepsy with cognitive impairment and depression.