Archives of general psychiatry
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Arch. Gen. Psychiatry · Jun 2011
Multicenter Study Comparative StudyFunctional impairment in elderly patients with mild cognitive impairment and mild Alzheimer disease.
The original mild cognitive impairment (MCI) criteria exclude substantial functional deficits, but recent reports suggest otherwise. Identifying the extent, severity, type, and correlates of functional deficits that occur in MCI and mild Alzheimer disease (AD) can aid in early detection of incipient dementia and can identify potential mechanistic pathways to disrupted instrumental activities of daily living (IADLs). ⋯ Mild IADL deficits are common in individuals with aMCI and should be incorporated into MCI criteria. Two IADLs--remembering appointments, family occasions, holidays, and medications and assembling tax records, business affairs, or other papers--appear to be characteristic of clinically significant cognitive impairment. In patients with aMCI, impairment in memory and processing speed and greater medial temporal atrophy were associated with greater IADL deficits.
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Arch. Gen. Psychiatry · Jun 2011
Controlled Clinical TrialAn effectiveness trial of group cognitive behavioral therapy for patients with persistent depressive symptoms in substance abuse treatment.
Although depression frequently co-occurs with substance abuse, few individuals entering substance abuse treatment have access to effective depression treatment. ⋯ Providing group cognitive behavioral therapy for depression to clients with persistent depressive symptoms receiving residential substance abuse treatment is associated with improved depression and substance use outcomes. These results provide support for a new model of integrated care.