Cognitive Health i i l h Alice Medalia PhD Alice Medalia, PhD Clinical Director of Cognitive Health Services New York Office of Mental Health New York Office of Mental Health Professor of Medical Psychology y gy Columbia University Medical Center
What is Cognitive Health? What is Cognitive Health? Across ethnic and racial groups people Across ethnic and racial groups people describe cognitive health as : staying sharp staying sharp • being right in the mind • having a positive mental outlook • having a positive mental outlook • being alert • having a good memory h i d • being socially involved
Good Functioning Requires g q Cognitive Cognitive Health Health Physical Physical Emotional Emotional Health Health Health Health
Cognitive Impairment in Depression Cognitive Impairment in Depression Cognitive Impairment in Depression Cognitive Impairment in Depression After 8 weeks of After 8 weeks of antidepressant treatment, cognition Intact remains impaired relative to healthy controls, even after t l ft Impaired 95% symptoms of depression improve depression improve. Shilyansky et al, Lancet Psychiatry 2016
What were you doing in the last 8 weeks? k ? Imagine having impaired attention and memory Imagine having impaired attention and memory
What Does Cognitive Impairment Look Like?
Functional Disability in Functional Disability in y Mood Disorders Mood Disorders Underperformance is common in these areas: • Academics • Occupational achievement • Interpersonal relationships Interpersonal relationships • Independent living • Community participation Community participation • Medication management
Dispelling a Myth Dispelling a Myth Dispelling a Myth Dispelling a Myth Diagnostic symptoms account for surprisingly little variance in everyday functional behaviors little variance in everyday functional behaviors and contribute poorly to the prediction of the breadth and persistence of functional impairment breadth and persistence of functional impairment experienced by individuals with mood disorders. COGNITION PREDICTS WORK & SOCIAL FUNCTIONING
Cognition can be Improved Cognition can be Improved Excitement to study and provide treatments for Excitement to study and provide treatments for cognition
Tools to Address Cognitive Health Tools to Address Cognitive Health • Cognition is embedded in the vocabulary of recovery • Medications and behavioral treatments address cognitive symptoms add ess cog e sy p o s • Thinking well is valued, assessed and addressed by all stakeholders addressed by all stakeholders
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