title: Screening for cognitive dysfunction in unipolar depression: Validation and evaluation of objective and subjective tools.
abstract: BACKGROUND
  Persistent cognitive dysfunction in unipolar depression (UD) contributes to socio-occupational impairment, but there are no feasible methods to screen for and monitor cognitive dysfunction in this patient group. The present study investigated the validity of two new instruments to screen for cognitive dysfunction in UD, and their associations with socio-occupational capacity.
  
  
  METHODS
  Participants (n=53) with UD in partial or full remission and healthy control persons (n=103) were assessed with two new screening instruments, the Danish translations of the Screen for Cognitive Impairment in Psychiatry (SCIP-D) and Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) and with established neuropsychological and self-assessment measures. Depression symptoms and socio-occupational function were rated with the Hamilton Depression Rating Scale and Functional Assessment Short Test respectively.
  
  
  RESULTS
  The SCIP-D and COBRA were valid for detection of objective and subjective cognitive impairment, respectively. The three parallel SCIP-D forms were equivalent. A combined SCIP-D-COBRA measure showed high sensitivity and good specificity for objective cognitive impairment (91% and 70%, respectively). There was no correlation between subjective and objective measures of cognition. Subjective cognitive difficulties correlated more with socio-occupational impairment (r=0.7, p<0.01) than did objective cognitive difficulties, for which there was a weak correlation with the executive skills domain only (r =-0.3, p=0.05).
  
  
  CONCLUSIONS
  A modest sample size.
  
  
  CONCLUSIONS
  The SCIP-D and COBRA are valid measures of objective and subjective cognitive impairment, respectively, and should ideally be implemented together in the screening for cognitive dysfunction in UD.
authors.affiliation: Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet Dep. 6233, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Electronic address: caroline.vintergaard.ott@regionh.dk.
authors.forename: Caroline Vintergaard
authors.initials: CV
authors.lastname: Ott
authors.affiliation: Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet Dep. 6233, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Electronic address: anne.juul.bjertrup@regionh.dk.
authors.forename: Anne Juul
authors.initials: AJ
authors.lastname: Bjertrup
authors.affiliation: Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet Dep. 6233, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Electronic address: johan.hoey.jensen@regionh.dk.
authors.forename: Johan Høy
authors.initials: JH
authors.lastname: Jensen
authors.affiliation: Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet Dep. 2031, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
authors.forename: Henrik
authors.initials: H
authors.lastname: Ullum
authors.affiliation: Psychiatric Center Hvidovre, Dep. 803A, Brøndbyøstervej 160, DK-2605 Brøndby, Denmark. Electronic address: rene.sjaelland@regionh.dk.
authors.forename: René
authors.initials: R
authors.lastname: Sjælland
authors.affiliation: Alberta Hospital Edmonton Neuropsychology, and the University of Alberta Faculty of Medicine and Dentistry, Box 307 (17480 Fort Road), Edmonton, Alberta, Canada T5J 2J7. Electronic address: spurdon@ualberta.ca.
authors.forename: Scot E
authors.initials: SE
authors.lastname: Purdon
authors.affiliation: Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Villarroel 170, Barcelona 08036, Catalonia, Spain. Electronic address: evieta@clinic.ub.es.
authors.forename: Eduard
authors.initials: E
authors.lastname: Vieta
authors.affiliation: Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet Dep. 6233, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Electronic address: lars.vedel.kessing@regionh.dk.
authors.forename: Lars V
authors.initials: LV
authors.lastname: Kessing
authors.affiliation: Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet Dep. 6233, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Electronic address: Kamilla@miskowiak.dk.
authors.forename: Kamilla W
authors.initials: KW
authors.lastname: Miskowiak
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000150:complications* / Q000175:diagnosis*; D003866:Depressive Disorder / Q000150:complications* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D015203:Reproducibility of Results; D012647:Self-Assessment; D012680:Sensitivity and Specificity
keywords: Assessment; Cognition; Depression; Mood disorder; Screening; Socio-occupational function