Undoubtedly, adopting a symptom-oriented rather than a purely diagnostic-based approach is essential for optimisation of depression treatments as Stefan Gold and Christian Otte suggest in their Correspondence.1 Symptoms do not respond equally to interventions and, indeed, research on their trajectories seems to be the way forward in precision psychiatry. However, both diagnostic (eg, DSM) and scale (eg, Montgomery-Åsberg Depression Rating Scale) instruments that are used to determine the presence of these symptoms usually restrict the assessment of cognition to one item, which could be summarised as a subjective report of impaired concentration or indecisiveness ...
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