THINC-it® cognition screening tool now clinically validated

In major depression, cognitive impairment – relative to matched healthy control individuals – can be reliably detected with the new, computerised THINC-it® tool. This free, self-administered 10–15-minute test integrates subjective and objective measures of cognition, and should be used in assessing patients and treatment.

In a recently published study1, which involved 14 centres in Canada, Australia and Europe, 100 patients aged 18–65 years with major depressive disorder (MDD) who were experiencing a recurrence were compared to 100 healthy control individuals matched for age, sex and education.  

On mean scores on the THINC-it® tool, 44% of patients with MDD were one standard deviation or more below healthy control individuals. Overall, 98% of healthy control individuals performed better than the mean score of patients with MDD. 

The authors, therefore, concluded that THINC-it® is a valid and sensitive tool for detecting cognitive dysfunction in people with major depression. 

In total, 90% of patients with MDD and control individuals successfully completed the THINC-it® battery. On average, patients with MDD took 10–15 minutes. Feedback from users was positive. 

Deficits in cognitive function among people who have MDD contribute to relatively poor social and workplace functioning 

THINC-it® includes the Choice Reaction Time task, the One-Back Test, the Digit Symbol Substitution Test, the Trail Making Test Part B and the Perceived Deficits Questionnaire for Depression 5-item version. These components were included because each is a relevant and validated measure, and because – when taken together – they cover the dimensions of executive function, learning and memory, attention and processing speed, all of which have been shown to be impaired by major depression. 

According to principal investigator Roger McIntyre (University of Toronto, Canada), deficits in cognitive function among people who have MDD contribute to relatively poor social and workplace functioning, even when mood improves with treatment. This suggests that cognition is an important mediator of outcome and should be actively assessed. 

Full neuropsychological examination is time-consuming and not generally available. Hence the need for a test that integrates subjective and objective measures of cognitive function and that is sufficiently user-friendly for routine application in primary care as well as in secondary care and research settings. 

In general, measurement-based care is likely to improve outcome in MDD, says Professor McIntyre, and THINC-it® is a good example of the value of measurement in practice. 

Although this is still to be established, the utility of THINC-it® in depression may extend to other mental health conditions, such as bipolar disorder and schizophrenia, in which cognitive function can be impaired. 

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