Department of Psychiatry and Pharmacology, University of Toronto, Mood Disorders Psychopharmacology Unit, University Health Network, Brain and Cognition Discovery Foundation, 399 Bathurst St, Toronto, ON, Canada M5T 2S8.
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada.
J Clin Psychiatry. 2017 Jul;78(7):873-881. doi: 10.4088/JCP.16m11329.
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).
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).
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.
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.
ClinicalTrials.gov identifier: NCT02508493.
验证 THINC-integrated 工具（THINC-it）——一种免费的、患者可自主操作的、计算机化的筛查工具，用于评估伴有重性抑郁障碍（MDD）的成年人的认知功能，其整合了主观和客观的认知功能测量指标。
对 100 名年龄在 18 至 65 岁之间、有反复发作的 MDD 病史、且当前正经历至少为中度严重程度的重性抑郁发作的患者（病例组）进行评估，并与年龄、性别和教育程度相匹配的 100 名健康对照者（对照组）进行比较。在 2016 年 1 月至 6 月期间，受试者完成了 THINC-it 测试，其中包括选择反应时识别任务（IDN）、数字记忆测试、数字符号替代测试、连线测试 B、抑郁障碍五项感知缺陷问卷（PDQ-5-D）的变体。
THINC-it 大约需要 10 到 15 分钟的时间来进行评估，并且能够检测出 MDD 成年患者的认知缺陷。在 THINC-it 的标准化平均分数中，有 44.4%的 MDD 成年患者的认知表现比健康对照组至少低 1.0 个标准差。基于计算得出的综合分数，该工具的整体相关性（r = 0.539，P <.001）具有可接受的一致性。各组成部分测试的相关性范围为-0.083（IDN）至 0.929（PDQ-5-D）。定性调查结果表明，在管理 THINC-it 方面，患者对其在评估和衡量患者所接受的治疗的恰当性和质量方面的影响表示高度满意和认可。
THINC-it 是一种用于检测伴有 MDD 的成年人认知功能障碍的有效、敏感的工具，它是免费的、易于使用的、并且可以快速实施。THINC-it 应纳入所有 MDD 患者的评估和测量中，尤其是在那些有持续功能障碍的患者中。
ClinicalTrials.gov 标识符：NCT02508493。
