Mobile cognitive testing in patients with schizophrenia: A controlled study of feasibility and validity

Abstract

Summary There is now abundant evidence that cognitive deficits are a core component of schizophrenia. Ecological momentary assessment (EMA) uses mobile technologies to provide lacking information concerning fluctuations in the cognitive functions and their immediate association with the expression of symptoms among individuals with this disorder. The present investigation examines the compliance rates, biases, and validity indicators of this methodology in patients with schizophrenia compared to healthy controls. Twenty-two outpatients with schizophrenia (50% with comorbid substance dependence comorbidity) and 27 healthy controls participated in this study. All participants received a traditional battery of neuropsychological assessments including the Stroop test and Letter-verbal fluency. EMA was also used to provide five electronic interviews per day over a one-week period. Two different versions of a brief cognitive test were administered alternately during the electronic interviews to assess executive functioning (a color-word interference task and letter-word generation task). Feasibility was examined as a function of compliance, fatigue and practice effects. Convergent validity was assessed by examining the correlation between neuropsychological test scores and the corresponding EMA executive assessments. Our findings indicate strong support for the overall feasibility of mobile cognitive testing in this population, and significant correlations between mobile cognitive tests and standard clinical measures support their convergent validity.