<b><i>Introduction:</i></b> Depressive disorders are the 4th leading cause of health problems and the 2nd leading cause of burden among all diseases. Almost all depressive disorder patients have cognitive impairments to a certain extend. Studies about cognitive impairments in depression had been conducted, but whether cognitive dysfunctions are the cause or the effect is still not clear. <b><i>Objectives:</i></b> To analyze the process of working memory and cognitive flexibility impairments in a rat model of depression. <b><i>Methods:</i></b> In this experimental study, chronic unpredictable mild stress (CUMS) was used as a model of depression in 30 rats (<i>Rattus novergicus</i>). Cognitive function was assessed with the <i>Morris water maze</i> and <i>attentional set shifting test</i>. <b><i>Results:</i></b> This study found a significant difference on day 21 in working memory (<i>p</i> = 0.002) and cognitive flexibility (<i>p</i> = 0.036), which continued to day 41 in working memory (<i>p</i> = 0.001) and cognitive flexibility (<i>p</i> = 0.020). In the CUMS model of depression, parameters peak on day 41 and reveal parameter changes in weight gain (<i>p</i> = 0.018), food intake (<i>p</i> < 0.001), changes in food intake (<i>p</i> = 0.001), and the sucrose preference (<i>p</i> = 0.005), elevated plus maze (<i>p</i> = 0.001), and light dark box tests (<i>p</i> = 0.020). <b><i>Conclusion:</i></b> In a rat model of depression, cognitive impairment preceded depression, but it might be caused by anxiety-like behavior that occurred in early stimulation of chronic unpredictable mild stress.
Forensic psychiatrists are often sought by the court of law to provide professional opinion on specific legal matters that have a major impact on the evaluee and possibly society at large. The quality of that opinion and recommendations rely on the quality of the analysis from the assessment results conducted by the psychiatrist. However, the definition and scope of a forensic psychiatric analysis is not clear. While existing literature on forensic psychiatric analysis generally includes organizing information, identifying relevant details, and formulating a set of forensic psychiatric opinions as components, there is no explicit and unified definition of these terms and process. This lack of clarity and guidelines may hinder forensic psychiatry from achieving its goal of providing objective information to the court or other relevant parties. Forensic psychiatric analysis exhibits numerous parallels to clinical reasoning in other fields of medicine. Therefore, this review aims to elaborate forensic psychiatric analysis through the lens of clinical reasoning, which has been developed by incorporating advances in cognitive sciences. We describe forensic psychiatric analysis through three prominent clinical reasoning theories: hypothetico-deductive model, illness script theory, and dual process theory. We expand those theories to elucidate how forensic psychiatrists use clinical reasoning not only to diagnose mental disorders, but also to determine mental capacities as requested by law. Cognitive biases are also described as potential threat to the accuracy of the assessment and analysis. Additionally, situated cognition theory helps elucidate how contextual factors influence risk of errors. Understanding the processes involved in forensic psychiatric analysis and their pitfalls can assist forensic psychiatrists to be aware of and try to mitigate their bias. Debiasing strategies that have been implemented in other fields of medicine to mitigate errors in clinical reasoning can be adapted for forensic psychiatry. This may also shape the training program of general psychiatrists and forensic psychiatrists alike.
Background: Children with cancer require special interventions and palliative care to improve their quality of life. The epidemiology of pediatric cancer is needed as a basis for determining health policy.
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