THINC-Integrated Tool Measures Cognition in Depression Disorder Screenings

depressed woman
depressed woman
The use of a recently developed computerized screening tool, THINC-it, provides both objective and subjective measures of cognitive function in adults with major depressive disorder.

Cognitive deficits recognized by the THINC-integrated tool, a recently developed integrated screening device for cognitive impairment in major depressive disorder (MDD), may be related to global and specific psychosocial deficits, underscoring the clinical importance of the THINC-integrated tool, according to analysis results published in the Journal of Clinical Psychiatry.

The researchers analyzed data from 3 studies that used the THINC-integrated tool and had inclusion criteria for a diagnosis of MDD. The lifetime depression group (N=127) included patients who were currently depressed (n=105) and patients who were remitted (n=22) from MDD. Patients classified as currently depressed had experienced primary symptoms of MDD during the past 2 weeks according to the Mini-International Neuropsychiatric Interview. Patients classified as remitted had a history of MDD but were symptom-free during the past 2 weeks according to the same interview. The lifetime depression classification was defined as currently depressed or remitted from MDD. The mean age of study participants was 42.35±15.68 years, 59% were women, and mean duration of education was 14.26±2.48 years. The THINC-integrated tool, which was used in the analysis, consists of 4 objective cognitive tests: Spotter (Choice Reaction Time), Symbol Check (n-back), CodeBreaker (Digit Symbol Substitution), and Trails (Trail Making Test part B).

Analysis across the groups indicated that reduced objective cognitive performance on the CodeBreaker (β =0.346, =.002), Trails tasks (β =0.232, P =.017), and greater perceived cognitive deficits on the 5-item Perceived Deficits Questionnaire for Depression (β =0.596, <.001) were linked to increased psychosocial dysfunction. Decreased performance on the CodeBreaker and Trails tasks was differentially associated with deficits in autonomy, occupational functioning, subjective cognition, and interpersonal relationships. Overall, performance in Spotter and Symbol Check was not linked to dysfunction. 

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The investigators noted that in participants with current compared with remitted MDD, the link between screening results and psychosocial dysfunction was less reliable, likely because of the smaller sample size.

“The current findings indicate that both objective cognitive outcomes and self-perceived cognitive deficits in the THINC-[integrated tool] are associated with global psychosocial dysfunction,” the researchers concluded.

Disclosure: One author declared affiliation with pharmaceutical companies. See reference for a full list of disclosures.


Knight MJ, Fourrier C, Lyrtzis E, et al. Cognitive deficits in the THINC-integrated tool (THINC-IT) are associated with psychosocial dysfunction in patients with major depressive disorderJ Clin Psychiatry. 2019;80(1):18m12472.