TY  - JOUR
AU  - McIntyre, Roger S
AU  - Lipsitz, Orly
AU  - Rodrigues, Nelson B
AU  - Subramaniapillai, Mehala
AU  - Nasri, Flora
AU  - Lee, Yena
AU  - Fehnert, Ben
AU  - King, James
AU  - Chrones, Lambros
AU  - Kratiuk, Kevin
AU  - Uddin, Sharif
AU  - Rosenblat, Joshua D
AU  - Mansur, Rodrigo B
AU  - McCue, Maggie
PY  - 2022
DA  - 2022/10/27
TI  - An App-Based Digit Symbol Substitution Test for Assessment of Cognitive Deficits in Adults With Major Depressive Disorder: Evaluation Study
JO  - JMIR Ment Health
SP  - e33871
VL  - 9
IS  - 10
KW  - depression
KW  - DSST
KW  - Digit Symbol Substitution Test
KW  - smartphone
KW  - technology
KW  - measurement-based care
KW  - cognition
AB  - Background: Cognitive dysfunction is an impairing core symptom of depression. Among adults with major depressive disorder (MDD) treated with antidepressants, residual cognitive symptoms interfere with patient-reported outcomes. The foregoing characterization of cognitive symptoms provides the rationale for screening and assessing the severity of cognitive symptoms at point of care. However, clinical neurocognitive assessments are time-consuming and difficult, and they require specialist expertise to interpret them. A smartphone-delivered neurocognitive test may offer an effective and accessible tool that can be readily implemented into a measurement-based care framework. Objective: We aimed to evaluate the use of a smartphone-delivered app-based version of the established Cognition Kit Digit Symbol Substitution Test (DSST) neurocognitive assessment compared to a traditional paper-and-pencil version. Methods: Convergent validity and test-retest reliability of the 2 versions were evaluated. Patient satisfaction with the app was also assessed. Results: Assessments made using the app-based Cognition Kit DSST were highly correlated with the standard paper-and-pencil version of the test, both at the baseline visit (r=0.69, df=27; P<.001) and at the end-of-study visit (r=0.82, df=27; P<.001), and they were positively evaluated by 30 patients as being user-friendly, easy to navigate, and preferable over the paper-and-pencil version of the DSST. However, although the app-based Cognition Kit DSST was validated in patients with MDD, it still needs to be evaluated in healthy controls. Conclusions: App-based DSST may facilitate a more personalized, convenient, and cost-effective method of cognitive assessment, helping to guide measurement-based care and psychotherapeutic and pharmacologic treatment options for patients with MDD. Trial Registration: ClinicalTrials.gov NCT03999567; https://tinyurl.com/2p8pnyv7 
SN  - 2368-7959
UR  - https://mental.jmir.org/2022/10/e33871
UR  - https://doi.org/10.2196/33871
UR  - http://www.ncbi.nlm.nih.gov/pubmed/36301615
DO  - 10.2196/33871
ID  - info:doi/10.2196/33871
ER  -