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Saturday, December 10, 2022

Mental health problems come with an added ‘cost’ of poor cognitive function – a neuropsychologist explains

Mental health problems come with an added 'cost' of poor cognitive function - a neuropsychologist explains

The research brief is a brief about interesting academic work.

big idea

All types of mental disorders come with a hidden cost in the form of cognitive dysfunction, including decreased memory, attention, executive functions and processing speed, according to a comprehensive study published in June 2021 in the journal Clinical Psychology Review by my colleagues and I. is included. ,

We found that diagnosable mental disorders, as well as some common symptoms such as anxiety and worry, have a so-called “cognitive value”. We called this phenomenon “The Sea Factor”—short for cognitive dysfunction. It can be defined as either low performance on cognitive tests or deficits in cognitive abilities such as attention and memory. Our analysis shows that it can be found in disorders and is an integral part of poor mental health.

Our team analyzed data from all existing meta-analyses and conducted a systematic review of cognitive function in all disorders recognized by the Diagnostic and Statistical Manual of Mental Disorders. We included 97 meta-analyses covering 29 disorders. In total, our study included data from over 200,000 individuals.

why it matters

In recent decades, mental disorders have become increasingly prevalent in the US and around the world, especially among young adults and adolescents. Even before the pandemic, 1 in 5 Americans suffered from a mental disorder.

In fact, the most comprehensive study ever to examine the worldwide prevalence of mental disorders estimated that 55% of Americans will meet criteria for at least one mental disorder in their lifetime. Specifically, that study – which was conducted 15 years ago – examined diagnosable disorders. But, in reality, the prevalence of lifetime experience of clinically meaningful symptoms is much higher in the general population. For example, one study found that although about 20% of Americans will meet formal criteria for major depressive disorder in their lifetime, 62% of Americans will experience meaningful symptoms of depression.

Since our findings suggest that poor mental health is at least somewhat associated with cognitive dysfunction, this type of deficit may be far more common than previously thought.

These findings are important because some mental disorders can be misdiagnosed on the basis of cognitive dysfunction. For example, a college student who struggles with obsessive-compulsive disorder should be expected to have some difficulties in areas such as concentration, organization, time management, and memory. However, in such a case, these cognitive challenges do not arise from conditions such as dyslexia or attention deficit hyperactivity disorder, but from OCD. This potential confusion can lead to misdiagnosis.

Indeed, ADHD, a disorder characterized by deficits in executive functions, is one of the most misdiagnosed disorders in all age groups. According to a 2010 study, about 20% of youth receiving ADHD and medication are misdiagnosed. In addition, there is evidence that even without a complete or formal diagnosis of ADHD, doctors very easily prescribe stimulant medications for inattentive symptoms.

Therefore, a lack of knowledge about the cognitive disorders associated with OCD in the above example may lead to inappropriate treatment. Indeed, stimulant drugs may increase irritability and anxiety in such individuals and may exacerbate cognitive dysfunction. It is therefore important that mental health professionals gain a better understanding of how mental health and cognitive dysfunction go hand in hand, especially in the context of misinterpretation of cognitive symptoms.

what is not yet known

Two major questions arise from the results of our study. First, why does any significant mental health problem come with a cost in the form of cognitive dysfunction? It seems surprising that different mental health disorders vary greatly in terms of symptoms and types of interventions. Our team is working to identify factors that negatively impact cognitive functioning, including low motivation, low effort, and low self-efficacy.

Second, what is the actual mechanism underlying this phenomenon? For example, if we find that general suffering is common to all mental disorders, what is the specific mechanism by which suffering hinders performance on cognitive tests? More research is needed to investigate these questions.

[You’re smart and curious about the world. So are The Conversation’s authors and editors. You can read us daily by subscribing to our newsletter.]

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