There are increasing concerns regarding long-term psychotropic polypharmacy prescribed for foster care youth 3.5 to 5 times more often than in at-home youth (Kreider et al., 2014). Polypharmacy risks include weight gain, glucose intolerance and type 2 diabetes. (De Hert et al., 2011). In view of these risks, novel interventions are essential to safeguard foster care youth from overmedication.

To present guidelines for identification and management of polypharmacy in foster care youth.

To demonstrate a novel intervention to monitor and diminish polypharmacy and enhance psychiatric care in foster care children.

Polypharmacy is identified using LA County Juvenile Court Mental Health Service (JCMHS) Psychotropic Parameters* to review medication consent forms from treating psychiatrists. Polypharmacy triggers an in-person JCHMS consultation. *(Parameters 3.9 for JCMHS PMAF Review, Revised May 2015).

JCMHS Psychotropic Parameters (summary):

• – age 0–5 years:

• – 2 or > psychotropic medications,

• – Any antipsychotic (*except Risperidone in ASD);

• – age 6–8 years:

• – 3 or > psychotropic medications;

• – age 9–17 years:

• – 4 or > psychotropic medications;

• – All age youth:

• – 2 or > psychotropic medications in the same class (antipsychotics, antidepressants, stimulants, mood stabilizers, alpha agonists).

Psychotropic medication doses in excess of recommended (*LA County Department of Mental Health Parameters 3.8 for use of Psychotropic Medications for Children and Adolescents).

Approximately 25% of JCMHS annual psychiatric consultations were initiated by JCMHS parameters for polypharmacy. Corresponding consultations included education and recommendations discussed with treating psychiatrists regarding polypharmacy and optimal psychiatric management.

JCMHS Psychotropic Parameters is a useful tool to identify polypharmacy and enhance psychiatric care of foster care youth.

The authors have not supplied their declaration of competing interest.

Results indicate a higher rate of admissions in adopted males than females, being attention deficit hyperactivity disorder and reactive attachment disorder of infancy or early childhood the most common diagnosis. Rate of readmission is higher in males.

The authors have not supplied their declaration of competing interest.

Working memory (WM) is the ability to retain and manipulate information during a short period of time. According to previous studies, children who have neurocognitive dysfunctions, such as ADHD and learning disorder were found to have a WM problem, which was associated with frontal lobe dysfunction, especially dysfunctions in dorsolateral prefrontal cortex.

In the present study, we developed the computer-based WM tasks for school-aged children, which help to provide a timely assessment of risk and preventive intervention for children with subclinical attention problems.

We evaluated the construct and concurrent validity of newly developed WM tasks.

A hundred and fourteen 8- to 10-year-old children were recruited. The newly developed, computer-based WM tasks consist of two domains:

– auditory-verbal WM;

– visual-spatial WM.

We examined the construct validity of the tasks through examining the developmental trend of the WM abilities with age. To determine the concurrent validity of those tasks, we conducted correlation analyses between the participants’ scores and their scores on well-known measures of verbal and visual WM; Arithmetic and Letter-Number Sequencing subtest of intelligence scale (KEDI WISC), and Corsi block test.

There are marked linear increasing trends of the response accuracy with age. Further, there were high correlations between the scores of two WM tasks and the corresponding scores of standardized assessment tools.

This study showed promising evidence for the validity of computer-based tasks assessing WM, which might have the utility for school-aged children in research and clinical settings.

The authors have not supplied their declaration of competing interest.

According to the attention deficit hyperactivity disorder (ADHD) treatment guidelines, atomoxetine (ATX) is a second line treatment after stimulants and therefore a serious monitoring of ATX prescribing is necessary to avoid inappropriate prescribing.

In most countries in Central Europe, except Germany, there is no data on drug consumption for ADHD medicines (expressed in defined daily dose (DDD)/ADHD patient/year).

The main purposes of this study were: calculate and present the pattern and evolution of national consumption in Slovenia expressed in the percentage of DDD/patient/year consumption for the period 2003–2012.

The national consumption and population data for this period were obtained from Slovenian databases. A DDD/ADHD patient/year was calculated. Only immediate-release methylphenidate (IR-MPH), methylphenidate-osmotic release oral delivery system (OROS-MPH) and ATX have been available and included in this study.

Less than 50% of patients with ADHD are treated with medications in Slovenia. A total consumption rose rapidly from 41.3 in 2003 to 148.5 DDD/ADHD patient/year in 2012. The total consumption for ATX and MPH is almost equal (140.9 for ATX and 150.3 for MPH in 2012). This result is lower as it has been seen in Germany (208 DDD/ADHD patient/year in 2008 for MPH).

In the last decade in Slovenia, the total consumption is increasing rapidly, which indicates a positive trend. This pattern (low total consumption) has not been seen in Germany. After the new drugs have been available on the Slovenian market, the total consumption rose rapidly.

The authors have not supplied their declaration of competing interest.

Eye movement recordings can provide information about higher-level processing of visual information. Recent evidence shows a novel role for eye vergence in orienting attention (Solé Puig et al., 2013). Based on such eye tracking data, the BGaze method (Braingaze; Spain) detects visual attention. The outcomes of the BGaze method have been applied to classify ADHD patients from healthy controls.

In this study, we validated the BGaze method.

We therefore recorded eye movements in children while performing a visual detection task.

We evaluated the BGaze method using 4 types of supervised machine learning algorithms. In total, 138 different trained models were tested. Nineteen ADHD diagnosed patients (children 7–14 years of age) and 19 healthy age matched controls were used to build the 138 models. We performed 30 times repeated random sub-sampling validation. In each repeated random split, training set consisted of 80% of the data and test set of the remaining 20%. Finally, all the 138 models were tested with a validation set consisting of 232 children, including 22 ADHD patients.

Across all the 138 models, BGaze method showed an average accuracy of 90.84% (minimum 86.21%; maximum, 95.26%) and an average AUC of 0.95 (minimum 0.90; maximum, 0.97). Best models gave accuracies of 92%, AUCs of 0.96 and FN and FP rates of 4.3% and 7.5%, respectively. Mean scores during the training-testing phase averaged 99.63%.

The BGaze method is robust, accurate, and can provide an objective tool supporting the clinical diagnosis of ADHD.

The authors have not supplied their declaration of competing interest.

Few child psychiatrists are well trained in family-based interventions for military families who experience significant trauma, intergenerational posttraumatic stress disorder, substance abuse, depression and high rates of suicide (Ramsawh et al., 2014). The innovative VA/UCLA/LACDMH Child and Adolescent Psychiatry Training program, sponsored jointly by the VA Greater Los Angeles Healthcare System (VA) and the Los Angeles County Department of Mental Health (LAC DMH), will address unmet needs of at-risk military families using a family-focused model also applicable to other families exposed to trauma.

To present the curriculum of the VA/UCLA/LACDMH training program and details of the collaboration between the LA VA and LAC DMH.

To highlight how innovative child psychiatry training programs can be developed through creative institutional collaborations.

The VA/UCLA/LACDMH program family-based model and FOCUS (Lester et al., 2011) intervention were structured to meet regulatory standards of child psychiatry training programs.

A specialized family-based child training program was created to meet the needs of at-risk military families while providing rigorous child and adolescent psychiatry training. Components Early Intervention Family Clinic for At-Risk Children provides family psychoeducation, and identifies children and adolescents at risk.

An evidence-based early intervention for at-risk military families to enhance resilience and mitigate stress through improved coping, increased problem solving, and effective communication.

A successful collaboration between the LA VA and LAC DMH can lead to an innovative family-based child psychiatry training program.

The authors have not supplied their declaration of competing interest.

Twenty percent of children and adolescent population are suffering from psychiatric disorders, according to World Health Organization. Above that, clinical work and previous published reports point to increase of self-harm behaviour incidence and prevalence in many countries, including Croatia.

To compare defence mechanisms in adolescent patients with deliberate self-harm behaviour and without it.

To explore differences in adaptive and maladaptive defence mechanisms in adolescent patients with self-harm behaviour and without this behaviour; to gain better insight in possible perception and functioning patterns in these two patient subgroups. To assess the effect of possible differences on early diagnostic procedure and therapeutic plan.

Defence Style Questionnaire (DSQ) was administered to 150 patients aged between 14 and 18 years on their first visit to child and adolescent psychiatrist. Sevety-nine patients had history of self-harm behaviour and 81 patients had negative anamnestic data on such behaviour.

Comparison of defence mechanisms in these two patient subgroups showed a statistically relevant difference in using defence mechanisms.

Results of this study showed significant difference between patients with self-harm behaviour and without such behaviour regarding used defence mechanisms. Awareness of specific mental patterns in patients with self-harm behaviour provides better assessment of suicidal risk and optimal individual approach planning.

The authors have not supplied their declaration of competing interest.

The cutaneous polymorphic eruption of pregnancy (PEP) is presented by skin lesions usually in the third trimester of gestation and about 13% of women also suffer from perinatal depression.

To determine the frequency of pruritic urticarial papules of gestation with and without perinatal depression.

To assess the maternal causes for polymorphic eruption of pregnancy (PEP) in patients with and without perinatal depression.

Cases and controls were matched on the grounds of maternal weight gain in gestation, hormonal changes, deficit in iron and zinc, dysregulation of hypothalamic pituitary axis, pre-maturity, pre-eclampsia, pre-term labour. Univariate and multivariate analysis, adjusting for important demographic factors and comorbodities was conducted to assess the relationship of PEP with and without perinatal depression in reduced and full models of ANOVA in regression analysis. (Reduced model Y = β0 + β1X1 + … and the full model Y = β0 + β1X1 + β2X2 + β3X3 + β4X4 + β5X5 + β6X6 + …)

Polymorphic eruption of pregnancy with perinatal depression was statistically significant in maternal weight gain in gestation [odds ratio (OR) 1.20; 95% (CI): 1.15–1.30], hormonal changes [(OR) 2.78; 95% (CI): 2.52–2.82], deficit in iron and zinc [(OR) 2.18; 95% (CI): 2.04–2.38], dysregulation of hypothalamic pituitary axis [(OR) 1.37; 95% (CI): 1.18–1.49] and was not statistically significant in pre-maturity, pre-eclampsia and pre-term labour in cases and controls.

Pruritic urticarial papules and plaques of gestation are commonly associated in patients with perinatal derpession.

The authors have not supplied their declaration of competing interest.

Major depressive disorder (MDD) affects approximately 15% of youth, half of who do not respond to standard treatment. One promising intervention is repetitive transcranial magnetic stimulation (rTMS). However, response is limited, highlighting the need to focus on biomarkers to predict treatment response.

To explore baseline biomarkers of response associated with rTMS treatment in adolescent MDD.

To determine the association between dorsolateral prefrontal cortex (DLPFC) glutamate levels, cortical thickness, and cerebral blood flow (CBF) with MDD symptomatology decrease after rTMS intervention.

Twenty-four MDD youth underwent 3 weeks of rTMS, baseline and post-intervention magnetic resonance imaging scans, and short echo proton magnetic resonance spectroscopy. Response was determined by a 50% reduction of depression scores.

Depressive symptoms decreased with rTMS (t = 8.304, P = 0.00). Glutamate levels differed significantly between responders and non-responders (t = 2.24, P = 0.0039), where higher glutamate changes were associated with a better response (r = 0.416, P = 0.038). Responders also exhibited thinner DLPFC (r = –0.797, P = 0.000) and lower CBF levels.

The development of biomarkers for rTMS represents a novel and encouraging technique for a personalized and effective treatment while reducing ineffective treatment costs and personal burden in adolescent MDD.

The authors have not supplied their declaration of competing interest.

To evaluate in adults the associations between persistent ADHD and comorbid psychiatric disorders and gender differences, among subjects from a population-based birth cohort.

Subjects were recruited from a birth cohort of all children born during 1976–1982 who remained in Rochester, MN after five years of age. Participating subjects with research-identified childhood ADHD (n = 232; mean age 27.0 years; 72% men) and non-ADHD controls (n = 335; mean age 28.6 years; 63% men) were administered a structured psychiatric interview (MINI-International Neuropsychiatric Interview) to assess current ADHD status and comorbid psychiatric disorders.

Among the 232 with research-identified childhood ADHD, 68 (49 men and 19 women) had persistent adult ADHD. Compared to subjects without childhood ADHD, adults with persistent ADHD were significantly more likely to have any (81% vs. 35%, P < 0.001) as well as each of the specific psychiatric comorbidities. The associations retained significance when stratified by gender and there were no significant gender by ADHD interactions on psychiatric disorders except for dysthymia with which ADHD was more strongly associated in women than men. Among subjects with persistent ADHD, externalizing psychiatric disorders were more common in men (73%) and internalizing disorders were more common in women (53%).

Persistent ADHD is associated with an increased risk of comorbid psychiatric disorders in both adult men and women. Clinicians treating adults with persistent ADHD need to be aware of comorbid psychiatric disorders, especially externalizing disorders for men and internalizing disorders for women.

The authors have not supplied their declaration of competing interest.

Chronic tics and Tourette syndrome (TS) can be comorbid with several neuropsychiatric conditions and may add to the complexity of children's clinical presentation and need for inpatient input.

To review the clinical notes of all children admitted to a National Children's Inpatient Unit (aged up to 12 years) over a 5-year period and analyse their demographic and clinical characteristics including the presence of chronic tics/TS.

To assess the clinical correlates of comorbid chronic tics/TS in an inpatient preadolescent population.

A retrospective naturalistic study of all patients admitted to our unit from 2009 to 2014 was conducted. Children with and without chronic tics/TS were compared in terms of age, gender, family history of mental illness, history of neurodevelopmental problems in siblings, medication on admission and at discharge, length of admission and functional outcomes using Chi2 and t-tests for categorical and continuous data respectively.

A total of 133 children (mean age = 11.2 years) were included. Twenty-five (18.8%) were diagnosed with chronic tics/TS. Autism spectrum disorder was the most commonly comorbid diagnosis (84%), with the second most common being an anxiety disorder/OCD (52%). Statistically significant higher percentages of learning disability, neurodevelopmental problems in siblings, medication at discharge and longer inpatient admissions were identified in children with tics compared with the rest of the sample. No other differences were found.

The prevalence of chronic tics/TS in children needing inpatient treatment is significant. In our sample, chronic tics/TS seem to represent a marker of increased neurodevelopmental deviance and overall symptom severity.

The authors have not supplied their declaration of competing interest.

The validity and diagnostic stability of acute and transient psychotic disorder (ATPD) has been questioned by several authors, since its introduction in the International Statistical Classification of Diseases (ICD-10).

To determine the overall diagnostic stability of ATPD in scientific literature.

A systematic review and meta-analysis of prospective studies and retrospective chart reviews. Computerized search was performed in MEDLINE/PubMed, EMBASE, and Google Scholar, using the terms: “acute and transient psychotic disorder”, or “acute psychosis”, and “stability”, or “outcome”, or “long-term”, or “follow-up”, or “course”. Search was restricted to works in English published between 1993 and 2015, according to ICD-10 criteria. Opinion articles, individual case reports, researches with less than ten subjects, and overlapping studies were excluded. Data analysis was conducted using MedCalc software, version 15.8. Statistical procedure was calculated for meta-analysis of proportions.

Twenty-six studies met the inclusion criteria (n = 10852). For methodological purposes, a distinction was made between short-term (less than 2 years), medium-term (between 2–7 years), and long-term stability (more than 7 years). For short-term group (k = 5), the overall stability was 60.69% (fixed effects model); Cochran's heterogeneity statistic Q = 14.9, I2 = 73.15%, P = 0.0049. For medium-term group (k = 15), it was 49.99%; Q = 181.6, I2 = 92.29%, P < 0.0001. For long-term group (k = 6), it was 61.86%; Q = 35.12, I2 = 92.29%, P < 0.0001.

The global stability of ATPD indicates at the validity of the construct, but should be redefined in future revisions of ICD, to clarify better diagnostic criteria, and more predictive power.

The authors have not supplied their declaration of competing interest.

Human factors have been reported as the reason behind the majority of car accidents. However, to date, no studies at least in the Arab world generally and Gulf area specifically, conducted a comprehensive examination of cognitive functioning as potential predictors of car accidents and driving violations.

Examining the role of cognitive functions e.g., verbal working memory, attentional control as predictors of traffic accidents and driving violations.

Examining the predictability of individual's cognition of occurrence of driving violations and accidents.

The study was carried on a sample of hundred and thirty two participants whose age ranged between 24 and 31 years. They were classified into groups of violators and non-violators, accident free and accident involved as well. Cognitive functioning were measured using self-reports and task performance, and a series of ANOVAS as well as stepwise multiple regressions were conducted to test the research hypothesis.

Findings showed significant differences between violators and non-violators and between the accident free and accident involved groups in almost all of the considered factors, except for the decision making factor. Moreover, Pearson product-moment correlations showed that there were significant negative correlations between age, driving violations, and cognitive performance and the accidents.

Human cognition such as executive functioning and mental planning are key factors for predicting driving behavior and traffic accidents. The study results have many implications in diagnosing and preventing or at least reducing driving violations and road accidents.

The author has not supplied his/her declaration of competing interest.

Previous transcranial magnetic stimulation (TMS) studies indicate that exposing the subjects to an emotionally valent stimulus results in larger motor evoked potentials (MEP). Up to date, no TMS studies have been conducted in order to investigate the effect of personal memories with emotional value on corticospinal excitability.

To investigate changes in corticospinal excitability and sensorimotor integration induced by retrieval of negative or neutral autobiographical memories (AM).

To contribute to a further characterization of neural circuits involved during the evocation of negative AM.

In 12 healthy volunteers, we recorded motor evoked potentials (MEPs) elicited by TMS pulses during the retrieval of negative AM or neutral AM. Furthermore, we also tested Short-interval Intracortical Inhibition (SICI), Intracortical facilitation (ICF), Short and Long afferent Inhibition (SAI and LAI) in the two different experimental conditions.

Retrieval of negative AM induced a larger increase in MEP amplitude (35.01%) compared to neutral AM (F(1,22) = 7.04, P = 0.013). Furthermore we showed that retrieval of Negative AM increasedn ICF (F(1,22) = 5, P = 0.03) and decrease SAI (F(1,22) = 7.04, P = 0.039). The other TMS parameters were different between conditions.

Our results indicate that evocation of negative AM induce a complex modulation of excitatory and inhibitory sensorimotor networks. Further studies are needed to explore the link of these electrophysiological biomarkers with the strength, valence and specificity of negative AM.

The authors have not supplied their declaration of competing interest.

Humans learn how to behave both through rules and instructions as well as through environmental experiences. It has been shown that instructions can powerfully control people's choices, often leading to a confirmation bias.

To compare learning parameters in reinforcement learning task with and without instructions.

We recruited 52 healthy adult control subjects (21 males, 31 females, age 30 ± 6.5 years). Participants completed Repeatable Battery of Neuropsychological Status (RBANSS). Twenty-seven participants completed additionally Probabilistic Selection Task (PST) while twenty-five participants completed Instructional Probabilistic Selection Task (IPST). To analyze learning parameters, we used Q-learning model with 3 parameters: learning rate due to positive and negative reinforcements as well as exploration-exploitation parameter.

Both groups did not differ with respect to cognitive functioning measured with RBANSS (immediate and delayed memory, visuospatial abilities, language and attention); however, participants who completed PST had trend-level statistically faster learning rates due to positive (P = 0.099) and negative reinforcements (0.057) in comparison to participants who completed IPST. Both groups did not differ with respect to exploration-exploitation parameter (0.409).

In healthy adults, interference of confirmation bias can influence learning speed independent of cognitive functioning (immediate and delayed memory, visuospatial abilities, language and attention).

The authors have not supplied their declaration of competing interest.

Seizure disorders have been identified in patients suffering from different types of dementia. However, the risks associated with the subtypes of those seizures have not been characterized.

To compare the occurrence of seizure disorders (partial and generalized) between patients with and without a dementia diagnosis from the OPTUM database.

All ages, and patients with full eligibility between January of 2005 to December of 2014, were included. Data from OPTUM, a de-identified, HIPAA compliant database, made up of 40.7 million private insured patient individual electronic health records from the US, were utilized. Using ICD-9 diagnoses, the occurrence of generalized or partial seizure disorders was identified. A comparison between patients with and without dementia was performed.

A total of 150,516 patient records had a dementia diagnosis, and, 56.38% of them were females. Patients with dementia when compared to those without dementia had higher risk for seizure disorders [odds ratio (OR) = 6.5 95% CI = 4.4–9.5]; grand mal status (OR = 6.5, 95% CI = 5.7–7.3); partial seizures (OR = 6.0, 95% CI = 5.5–6.6); motor simple partial status (OR = 5.6, 95% CI = 3.5–9.0); epilepsy (OR = 5.0, 95% CI = 4.8–5.2); complex partial epileptic seizures (OR = 4.9, 95% CI = 4.6–5.2); generalized convulsive epilepsy (OR = 4.8, 95% CI = 4.5–5.0); localization-related epilepsy (OR = 4.5, 95% CI = 4.1–4.9); petit mal status (OR = 4.2, 95% CI = 2.9–6.1); fits convulsions (OR = 3.5, 95% CI = 3.4–3.6); and complex febrile seizure (OR = 2.5, 95% CI = 1.6–3.9).

The present study confirms that patients with dementia have higher risks for either generalized or partial seizures disorders when compared with patients without dementia.

The authors have not supplied their declaration of competing interest.

The neuropathological features of Alzheimer's disease (AD) are deposition of amyloid plaques, neurofibrillary tangles and neuro-inflammation. Among these, neuro-inflammation is a common pathological substrate of neurodegenerative disease, such as AD, and Parkinson disease.

Herein, we tested whether the inhibition of bromodomain and extra-terminal domain (BET) protein, a critical regulators of transcription in neurons, could attenuate the neuronal cell death and amyloid beta aggregation using rat primary cortical neurons. We also investigated whether a BET inhibitor could prevent the inflammatory processes and cognitive decline in an animal model of AD.

The effects of BET inhibition on neuronal cell death were assessed in the followings:

– cell viability and reactive oxygen species generation;

– enzyme activity of tPA/PAI-1 measured by casein zymography;

– the signal pathways including BDNF/CREB and MAPKs using western blotting;

– the effects on inflammatory responses in an animal model of AD using immunohistochemistry.

JQ1, an inhibitor of Brd2/4 protein, significantly decreased the neuronal cell death in mixed cortical neurons in concentration-dependent manner but not in pure neurons. JQ1 increased the enzyme activity of tPA, which decreased the expression of Brd2 protein. JQ1 also decreased the ROS generation and decreased cleaved caspase-3 expression. Moreover, Brd2 inhibition by transfection of Brd2 siRNA reduced amyloid beta aggregation.

Our results suggested that BET inhibition might have therapeutic potential for AD. That is, Brd2 inhibition by JQ1 can prevent the neuronal cell death and neuroinflammation as well as amyloid beta aggregation through regulation of tPA/PAI-1 system.

The authors have not supplied their declaration of competing interest.

Fluency tasks, e.g. verbal, design fluency test, etc. are often used in the evaluation of cognitive function in patients with schizophrenia. In the standard approach, the test result is the sum of stimuli generated in a given time period. However, this approach does not allow to determinate of what strategies are used by subjects to regulate the cognitive engagement during task execution.

To investigate the specific dynamic profile of fluency tests performance comparing with healthy controls.

Thirty patients diagnosed with schizophrenia and 30 demographically matched healthy controls took part in the study. Participants performed two tests: COWAT (3 trials) and Ruff Figural Fluency Test in accordance with the original instructions. During the generation of these stimuli, the investigator wrote down their quantity in 15-second intervals, which enables the assessment of cognitive engagement variability in different parts of the whole time (1 minute).

Comparison of cognitive engagement variation in both fluency tests showed statistically significant differences. The differences in repeated measures ANOVA with group as an independent variables reached P < 0.0001. Factor differentiating the profiles in verbal and figural fluency was first 15 seconds after the tasks started.

The beginning of task was the most difficult part for patients with schizophrenia, which may indicate that the overall worse performance of fluency tests is associated with significant difficulties in mobilizing the cognitive activity.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The term Pseudodementia, as presented by Kiloh, is being used to describe the clinical image characterized by depression combined with impairment in cognitive functions which reacts positively in treatment with antidepressants.

To explore the aspects that make this condition unique, so that mental health professional will be able to use the proper psychometric tools when they face patients with confusing symptoms.

Hundred and thirty-one participants were recruited from the B’ Psychiatric Clinic of G.H.N.P “Agios Panteleimon” and Day Center of Alzheimer's Disease in Amarousion, with 56 (42.7%) males and 75 (57.3%) females. All participants were administered the MoCA and the DASS21 questionnaires. Statistical analysis was performed with SPSS21.

The findings reported a significant difference in the scores of MoCA done by patients with dementia (M = 13.9, SD = 5.4) and patients with depression (M = 20.5, SD = 4.9) while both groups scored below the accepted scores indicating cognitive impairment [CI]. However, analysis showed that in the following sectors of MoCA, depressive patients scored significantly higher than demented ones: visuospatial (MD = 0.651), clock (MD = 1.288), orientation (MD = 1.212) and delayed recall (MD = 1.329).

Findings shows a significant pattern in the difference between depressed and patients with cognitive impairment. These findings suggest that mental health professionals should use neuropsychological measurements like MoCA when evaluating such cases in order to be able to diagnose effectively cases of pseudodementia.

The authors have not supplied their declaration of competing interest.