The THINC-integrated tool (THINC-it) screening assessment for cognitive dysfunction: Validation in patients with major depressive disorder

Roger S. McIntyre, Michael W. Best, Christopher R. Bowie, Nicole E. Carmona, Danielle S. Cha, Yena Lee, Mehala Subramaniapillai, Rodrigo B. Mansur, Harry Barry, Bernhard T. Baune, Larry Culpepper, Philippe Fossati, Tracy L. Greer, Catherine Harmer, Esther Klag, Raymond W. Lam, Hans Ulrich Wittchen, John Harrison

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objective: To validate the THINC-integrated tool (THINC-it).a freely available, patient-administered, computerized screening tool integrating subjective and objective measures of cognitive function in adults with major depressive disorder (MDD). Methods: Subjects aged 18 to 65 years (n = 100) with recurrent MDD experiencing a major depressive episode of at least moderate severity were evaluated and compared to age-, sex-, and education-matched healthy controls (n = 100). Between January and June 2016, subjects completed the THINC-it, which includes variants of the Choice Reaction Time Identification Task (IDN), One-Back Test, Digit Symbol Substitution Test, Trail Making Test.Part B, and the Perceived Deficits Questionnaire for Depression.5-item (PDQ-5-D). Results: The THINC-it required approximately 10 to 15 minutes for administration and was capable of detecting cognitive deficits in adults with MDD. A total of 44.4% of adults with MDD exhibited cognitive performance at ≥ 1.0 SD below that of healthy controls on standardized mean scores of the THINC-it. Concurrent validity of the overall tool, based on a calculated composite score, was acceptable (r = 0.539, P <.001). Concurrent validity of the component tests ranged from -0.083 (IDN) to 0.929 (PDQ-5-D). Qualitative survey results indicated that there was a high level of satisfaction and perceived value in administering the THINC-it regarding its impact on the appropriateness and quality of care being received. Conclusions: The THINC-it is a valid and sensitive tool for detecting cognitive dysfunction in adults with MDD that is free, easy to use, and rapidly administered. The THINC-it should be incorporated into the assessment and measurement of all patients with MDD, particularly among those with enduring functional impairment.

Original languageEnglish (US)
Pages (from-to)873-881
Number of pages9
JournalJournal of Clinical Psychiatry
Volume78
Issue number7
DOIs
StatePublished - Jul 1 2017

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Major Depressive Disorder
Trail Making Test
Sex Education
Quality of Health Care
Cognition
Reaction Time
Cognitive Dysfunction

ASJC Scopus subject areas

  • Psychiatry and Mental health

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The THINC-integrated tool (THINC-it) screening assessment for cognitive dysfunction : Validation in patients with major depressive disorder. / McIntyre, Roger S.; Best, Michael W.; Bowie, Christopher R.; Carmona, Nicole E.; Cha, Danielle S.; Lee, Yena; Subramaniapillai, Mehala; Mansur, Rodrigo B.; Barry, Harry; Baune, Bernhard T.; Culpepper, Larry; Fossati, Philippe; Greer, Tracy L.; Harmer, Catherine; Klag, Esther; Lam, Raymond W.; Wittchen, Hans Ulrich; Harrison, John.

In: Journal of Clinical Psychiatry, Vol. 78, No. 7, 01.07.2017, p. 873-881.

Research output: Contribution to journalArticle

McIntyre, RS, Best, MW, Bowie, CR, Carmona, NE, Cha, DS, Lee, Y, Subramaniapillai, M, Mansur, RB, Barry, H, Baune, BT, Culpepper, L, Fossati, P, Greer, TL, Harmer, C, Klag, E, Lam, RW, Wittchen, HU & Harrison, J 2017, 'The THINC-integrated tool (THINC-it) screening assessment for cognitive dysfunction: Validation in patients with major depressive disorder', Journal of Clinical Psychiatry, vol. 78, no. 7, pp. 873-881. https://doi.org/10.4088/JCP.16m11329
McIntyre, Roger S. ; Best, Michael W. ; Bowie, Christopher R. ; Carmona, Nicole E. ; Cha, Danielle S. ; Lee, Yena ; Subramaniapillai, Mehala ; Mansur, Rodrigo B. ; Barry, Harry ; Baune, Bernhard T. ; Culpepper, Larry ; Fossati, Philippe ; Greer, Tracy L. ; Harmer, Catherine ; Klag, Esther ; Lam, Raymond W. ; Wittchen, Hans Ulrich ; Harrison, John. / The THINC-integrated tool (THINC-it) screening assessment for cognitive dysfunction : Validation in patients with major depressive disorder. In: Journal of Clinical Psychiatry. 2017 ; Vol. 78, No. 7. pp. 873-881.
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AU - Best, Michael W.

AU - Bowie, Christopher R.

AU - Carmona, Nicole E.

AU - Cha, Danielle S.

AU - Lee, Yena

AU - Subramaniapillai, Mehala

AU - Mansur, Rodrigo B.

AU - Barry, Harry

AU - Baune, Bernhard T.

AU - Culpepper, Larry

AU - Fossati, Philippe

AU - Greer, Tracy L.

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AU - Wittchen, Hans Ulrich

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N2 - Objective: To validate the THINC-integrated tool (THINC-it).a freely available, patient-administered, computerized screening tool integrating subjective and objective measures of cognitive function in adults with major depressive disorder (MDD). Methods: Subjects aged 18 to 65 years (n = 100) with recurrent MDD experiencing a major depressive episode of at least moderate severity were evaluated and compared to age-, sex-, and education-matched healthy controls (n = 100). Between January and June 2016, subjects completed the THINC-it, which includes variants of the Choice Reaction Time Identification Task (IDN), One-Back Test, Digit Symbol Substitution Test, Trail Making Test.Part B, and the Perceived Deficits Questionnaire for Depression.5-item (PDQ-5-D). Results: The THINC-it required approximately 10 to 15 minutes for administration and was capable of detecting cognitive deficits in adults with MDD. A total of 44.4% of adults with MDD exhibited cognitive performance at ≥ 1.0 SD below that of healthy controls on standardized mean scores of the THINC-it. Concurrent validity of the overall tool, based on a calculated composite score, was acceptable (r = 0.539, P <.001). Concurrent validity of the component tests ranged from -0.083 (IDN) to 0.929 (PDQ-5-D). Qualitative survey results indicated that there was a high level of satisfaction and perceived value in administering the THINC-it regarding its impact on the appropriateness and quality of care being received. Conclusions: The THINC-it is a valid and sensitive tool for detecting cognitive dysfunction in adults with MDD that is free, easy to use, and rapidly administered. The THINC-it should be incorporated into the assessment and measurement of all patients with MDD, particularly among those with enduring functional impairment.

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