OBJECTIVES:To investigate neurocognitive, psychosocial, and quality of life (QoL) outcomes in children with Multisystem Inflammatory Syndrome in Children (MIS-C) seen 3-6 months after PICU... Show moreOBJECTIVES:To investigate neurocognitive, psychosocial, and quality of life (QoL) outcomes in children with Multisystem Inflammatory Syndrome in Children (MIS-C) seen 3-6 months after PICU admission. DESIGN:National prospective cohort study March 2020 to November 2021. SETTING:Seven PICUs in the Netherlands. PATIENTS:Children with MIS-C (0-17 yr) admitted to a PICU. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Children and/or parents were seen median (interquartile range [IQR] 4 mo [3-5 mo]) after PICU admission. Testing included assessment of neurocognitive, psychosocial, and QoL outcomes with reference to Dutch pre-COVID-19 general population norms. Effect sizes (Hedges' g) were used to indicate the strengths and clinical relevance of differences: 0.2 small, 0.5 medium, and 0.8 and above large. Of 69 children with MIS-C, 49 (median age 11.6 yr [IQR 9.3-15.6 yr]) attended follow-up. General intelligence and verbal memory scores were normal compared with population norms. Twenty-nine of the 49 followed-up (59%) underwent extensive testing with worse function in domains such as visual memory, g = 1.0 (95% CI, 0.6-1.4), sustained attention, g = 2.0 (95% CI 1.4-2.4), and planning, g = 0.5 (95% CI, 0.1-0.9). The children also had more emotional and behavioral problems, g = 0.4 (95% CI 0.1-0.7), and had lower QoL scores in domains such as physical functioning g = 1.3 (95% CI 0.9-1.6), school functioning g = 1.1 (95% CI 0.7-1.4), and increased fatigue g = 0.5 (95% CI 0.1-0.9) compared with population norms. Elevated risk for posttraumatic stress disorder (PTSD) was seen in 10 of 30 children (33%) with MIS-C. Last, in the 32 parents, no elevated risk for PTSD was found. CONCLUSIONS:Children with MIS-C requiring PICU admission had normal overall intelligence 4 months after PICU discharge. Nevertheless, these children reported more emotional and behavioral problems, more PTSD, and worse QoL compared with general population norms. In a subset undergoing more extensive testing, we also identified irregularities in neurocognitive functions. Whether these impairments are caused by the viral or inflammatory response, the PICU admission, or COVID-19 restrictions remains to be investigated. Show less
Monahan, R.C.; Blonk, A.M.E.; Huizinga, T.W.J.; Kloppenburg, M.; Middelkoop, H.A.M.; Wee, N.J.A. van der; Steup-Beekman, G.M. 2022
Objective To compare cognitive function between patients with different phenotypes of neuropsychiatric systemic lupus erythematosus (NPSLE) and assess its association with brain and white matter... Show moreObjective To compare cognitive function between patients with different phenotypes of neuropsychiatric systemic lupus erythematosus (NPSLE) and assess its association with brain and white matter hyperintensity (WMH) volumes. Methods Patients attending the Leiden University Medical Centre NPSLE clinic between 2007 and 2015 without large brain infarcts were included (n=151; 42 +/- 13 years, 91% women). In a multidisciplinary consensus meeting, neuropsychiatric symptoms were attributed to systemic lupus erythematosus (SLE) (NPSLE, inflammatory (n=24) or ischaemic (n=12)) or to minor/non-NPSLE (n=115). Multiple regression analyses were performed to compare cognitive function between NPSLE phenotypes and to assess associations between brain and WMH volumes and cognitive function cross-sectionally. Results Global cognitive function was impaired in 5%, learning and memory (LM) in 46%, executive function and complex attention (EFCA) in 39% and psychomotor speed (PS) in 46% of all patients. Patients with inflammatory NPSLE showed the most cognitive impairment in all domains (p <= 0.05). Higher WMH volume associated with lower PS in the total group (B: -0.14 (95% CI -0.32 to -0.02)); especially in inflammatory NPSLE (B: -0.36 (95% CI -0.60 to -0.12). In the total group, lower total brain volume and grey matter volume associated with lower cognitive functioning in all domains (all: 0.00/0.01 (0.00;0.01)) and lower white matter volume associated with lower LM, EFCA and PS (all: 0.00/0.01 (0.00;0.01)). Conclusion We demonstrated that an association between brain and WMH volumes and cognitive function is present in patients with SLE, but differs between (NP)SLE phenotypes. WMHs associated with PS especially in inflammatory NPSLE, which suggests a different, potentially more severe underlying pathophysiological mechanism of cognitive impairment in this phenotype. Show less
Since Antiquity, “active cognition” has been a problematic notion in Aristotelian scholarship. Part of the problem is the definition of what counts as “active”. In the first part of this paper I... Show moreSince Antiquity, “active cognition” has been a problematic notion in Aristotelian scholarship. Part of the problem is the definition of what counts as “active”. In the first part of this paper I shall offer a short survey on various contenders for “active” perceptual cognition defended in recent interpretations of Aristotle, by way of introduction to the more complicated problems of “active” intellectual cognition. In the second part of the paper I will offer—in outline—my interpretation of Aristotle’s theory of intellectual cognition, which takes the most recent findings in the area of perceptual cognition as a starting point. Here I pursue the analogy that Aristotle sets up between perception and intellection throughout the De anima. In the third part of the paper I shall examine a number of influential accounts of active intellectual cognition found in the corpus of Alexander of Aphrodisias, in particular Mantissa 2–5 (also known as De intellectu). These accounts each develop the analogies offered in Aristotle’s De anima III.5 in their own way. Show less
This review of the development and current status of psychology in Africa focuses on Africa south of the Sahara, excluding South Africa. The author discusses the research topics which have... Show moreThis review of the development and current status of psychology in Africa focuses on Africa south of the Sahara, excluding South Africa. The author discusses the research topics which have attracted the attention of psychologists in Africa, including perception (illusions, pictorial representation and perception), developmental psychology, cognitive development, intelligence, social psychology, and psychiatric and psychological disorders. Bibliogr., notes, ref Show less
The method of survey followed in this study is that of the bibliographical approach, i.e. a descriptive analysis of publications in terms of a number of categories. Presented is an analysis of the... Show moreThe method of survey followed in this study is that of the bibliographical approach, i.e. a descriptive analysis of publications in terms of a number of categories. Presented is an analysis of the titles in J.C. Hoorweg and H.C. Marais, Psychology in Africa. A bibliography (Leiden, 1966). In this bibliography, publications were included irrespective of quality, but confidential reports or papers pertaining to white subjects only were omitted. The 1312 entries were categorized in terms of: year of publication; field of psychology; geographical location; language of publication; publication medium. Extracted from these data were cross-tables: year of publication/field of psychology; year of publication/geographical location; language of publication/year of publication/field of psychology. Ref., notes, tables Show less
