To explore how health and social care professionals (HSCPs) in the UK conceptualise and respond to cognitive dysfunction in depression, including its potential long-term implications for brain health and dementia risk.

A qualitative, semi-structured interview study. Data was analysed using a code-book approach to thematic analysis.

The study was conducted in the UK, with HSCPs from diverse professional backgrounds including general practitioner, psychology, psychiatry, mental health nursing, psychological well-being practitioner and occupational therapy. A total of 12 participants were recruited via purposive and convenience sampling.

Three master themes were developed, (1) Cognitive dysfunction in depression, (2) Persistence of cognitive dysfunction and (3) Depression and dementia risk. HSCPs expressed challenges in screening for cognitive dysfunction in depression, particularly as dementia-related screening tools were used which may not be sensitive enough to detect depression-related cognitive deficits. A number of potential explanations were reported as to why cognitive dysfunction may persist after mood symptoms have lifted. These included substance misuse, role of education, neurological conditions and depression as a prodrome to dementia. Depression as a potential risk factor for poorer brain health in the context of dementia risk reduction was not communicated in clinical settings to service users. Barriers to communication included lack of evidence base on depression as a potential risk factor, as well as lack of guidance on communication practices in the context of mental health issues.

Cognitive dysfunction in depression is a complex phenomenon and remains under-explored. Challenges around identification and screening indicate a need for validation studies of cognitive screening measures for use in mood disorders, as well as pilot, acceptability and feasibility trials of interventions targeting cognitive functioning in mood disorders. Mixed-methods research is warranted to understand whether guidance on communicating depression as a risk factor for brain health is required and/or justified.

The prevalence of chronic kidney disease (CKD) is increasing at an alarming rate worldwide, leading to a growing number of patients developing kidney failure and requiring haemodialysis (HD). HD prolongs life and improves health, but it imposes substantial physical, nutritional, psychological and financial demands on patients. Patients on HD often endure a high symptom burden, which significantly impairs their lives.

The study aimed to explore and describe the lived experiences of patients residing in rural areas of Pakistan receiving HD.

A transcendental phenomenology.

Dialysis unit of a tertiary care hospital in Mirpur, AJK, Pakistan.

Twenty village-based patients with CKD receiving HD were recruited through a purposive sampling technique.

The data were collected through unstructured, in-depth, face-to-face interviews using an interview guide, as well as observation and document analysis. Thematic analysis used a Colaizzi seven-step method to derive key themes from the data.

Five major themes emerged after the data analysis, reflecting the complex symptom burden experienced by patients: (1) Physical manifestations and loss of independence due to persistent pain and fatigue, leading to increased dependency in daily activities. (2) Emotional and cognitive impact characterised by emotional distress, including anxiety, helplessness and cognitive disturbances such as poor concentration and mental fatigue. (3) Challenges with dietary management and lifestyle adaptation due to difficulties in adhering to dietary and fluid restrictions, further complicated by limited resources, lack of individualised guidance and cultural dietary practices. (4) Financial and logistical hardships, including out-of-pocket expenses, loss of income due to reduced work capacity and geographic barriers, significantly affecting treatment adherence and continuity of care. (5) Post-dialysis experiences and side effects. Patients expressed diverse experiences: some mentioned transient relief after HD, while others described ongoing side effects.

Patients with CKD on HD may face multiple symptoms that impact physical, emotional, cognitive, dietary, financial and social domains, which potentially contribute to reduced quality of life. Persistent symptoms and limited support highlight the need for holistic, patient-centred care strategies that address their physical, emotional, psychosocial and financial challenges, particularly in rural and underserved populations.

Heightened rates of mental illness among children, young people and forcibly displaced adults are well-documented. Despite this, access to care in host countries is often low. Problem-management plus (PM+) is an intervention developed by the WHO that can be delivered through task-shifting by lay counsellors and has been shown to be effective in numerous studies. At the same time, it has been shown that PM+ has a limited effect on traumatic stress symptoms, a common problem among forcibly displaced individuals. In turn, to further these benefits, a novel emotional processing (EP) module has been developed to be adjunctively delivered alongside PM+(PM+EP).

The current study is a randomised controlled feasibility and acceptability study. 60 participants aged 16–25 will be randomly allocated to either PM+, PM+EP or care as usual. The primary outcome of this study will be the feasibility and acceptability of the delivery of PM+EP in forcibly displaced youth. Secondary outcomes are self-rated measures of distress, depression and anxiety, post-traumatic stress disorder, personally identified problems, hope, use of services and medications, general well-being and social support.

Following ethical approval in February 2024, recruitment commenced in October 2024. Study completion is anticipated by December 2025. Findings will be disseminated via peer-reviewed publications, conference presentations and communication with relevant stakeholders.

NCT06878092.