A study reported in the December 2007 Journal of Psychosomatic Research examined cognitive complaints in head-injured patients referred to the emergency department of a level 1 trauma center in the Netherlands. A sample of 79 patients (ranging in age from 18 to 60) who had been admitted for mild traumatic brain injury were followed up over six months post-admission. In addition to a battery of neuropsychological tests and use of the Rivermead Postconcussional Symptoms Questionnaire (RPSQ), patients were also asked to self-monitor their cognitive and memory problems over a 12-day period. Results indicated that 39 per cent of the sample self-reported cognitive problems. These complaints were strongly related to lower educational levels, emotional distress, personality, and poorer physical functioning (especially fatigue) but not to actual extent of injury. Severity of self-reported cognitive complaints was found not to be associated with the patients' daily observations of cognitive problems or with outcome on a range of neuropsychological tests. The researchers concluded that self-reported cognitive complaints were more strongly related to preexisting personality factors, as well as physical and emotional problems rather than actual cognitive impairments. This would suggest that treatment of emotional distress and fatigue may also reduce cognitive complaints. They also concluded that neuropsychological screening and daily monitoring of complaints is a useful method to gather information about the frequency and pattern of cognitive problems in regular life.