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optimize treatment expectancies are capable of improving treatment outcomes. We aimed to compare trajectories of cognitive performance in individuals diagnosed with dementia with and without severe mental illness (SMI). Retrospective cohort study. We used data from a large longitudinal mental healthcare case register, the Clinical Record Interactive Search (CRIS), at the South London and Maudsley NHS Foundation Trust (SLaM) which provides mental health services to four south London boroughs. Our sample (N = 4718) consisted of any individ