The interplay between cognition, depression, anxiety, and sleep in primary Sjogren’s syndrome patients, 2022, Goulabchand et al

Abstract

Primary Sjögren’s syndrome (pSS) is an autoimmune disease with frequent neurological involvement. Memory complaints are common, but their precise patterns remain unclear. We wanted to characterize patterns of neurocognitive profiles in pSS patients with cognitive complaints.

Only pSS patients with memory complaints were included, prospectively. Cognitive profiles were compiled through a comprehensive cognitive evaluation by neuropsychologists. Evaluations of anxiety, depression, fatigue, sleep disorders and quality of life were performed for testing their interactions with cognitive profiles.

All 32 pSS patients showed at least borderline cognitive impairment, and 17 (53%) exhibited a pathological cognitive profile: a hippocampal profile (37%), a dysexecutive profile (22%), and an instrumental profile (16%) (possible overlap). Regarding the secondary objectives: 37% of patients were depressed, and 48% exhibited a mild-to-severe anxiety trait. Sleep disorders were frequent (excessive daytime sleepiness (55%), high risk for sleep apnea (45%), and insomnia (77%)).

Cognitive impairments could not be explained alone by anxiety, depression or sleep disorders. Fatigue level was strongly associated with sleep disorders. Our study highlights that cognitive complaints in pSS patients are supported by measurable cognitive impairments, apart from frequently associated disorders such as depression, anxiety or sleep troubles. Sleep disorders should be screened.

Open access: https://www.nature.com/articles/s41598-022-17354-1

 

Those small tells about what they mean when they say things like "a complex interplay of biological, psychological and social factors", and when they find that they can't pin it all on psychology they're basically like: "uh, didn't expect that, in fact we're basically stumped, WTH?".

Why would those impairments be explained alone by anxiety, depression or sleep disorders? That's not much of a complex interplay of anything, it's the same old "you're failing at doing simple, normal things that everyone can do, you're doing them wrong".

Especially when neither anxiety nor depression have any meaningful definition beyond having symptoms. It's completely circular logic where even where biology should matter, it's simply labeled psychological and no one thinks twice about the implications of doing that.