CogScreen: Validating cognitive screening in young people with first-episode psychosis

The primary aim of this study is to validate a cognitive screening tool for young people with first-episode psychosis (FEP). We aim to evaluate the classification accuracy (relative to a neuropsychological assessment reference standard) and test-retest reliability of two cognitive screening tools in young people with FEP: the Screen for Cognitive Impairment in Psychiatry (SCIP) and Montreal Cognitive Assessment (MoCA). All participants (N=350) will complete both cognitive screening measures (MoCA and SCIP), neurodevelopment assessment, psychiatric assessment, and other supplementary measures (e.g., other clinical measures and acceptability questionnaires). The assessments will be separated into two days: day 1) cognitive screening tests and psychiatric and developmental assessment, and day 2) full neuropsychological assessment. Day 1 is estimated to take 3 hours. The self-report measures will be split across both days to reduce participant burden, and will either be completed in person or the participant may choose to complete these measures at home. The assessments on each day will be completed by separate members of the research team, ideally conducted within seven days of each other. The assessment will be completed by a trained research assistant and will be administered under the remote supervision of a clinical neuropsychologist. The cognitive screening measures, neurodevelopmental and psychiatric assessments, and full neuropsychological assessment will likely occur at each of the participating sites (e.g., Orygen Specialist Program, Headspace) or at a location in the community (e.g., local library). The self-report supplementary measures will be completed in person or the participant may choose to receive a link to complete these measures at home. Test-retest assessment time-point (N=120) The SCIP and MoCA will be re-administrated to a sample of 120 people who completed the classification accuracy component of the study after two weeks (T2). Version 1 of the MoCA and SCIP will be administered to 60 consecutive participants and Version 2 to 60 consecutive participants for the retest reliability part of this study to determine the role of practice effects in the test-retest analysis. Both Version 1 and Version 2 of the MoCA and SCIP are validated measures and follow the same structure and scoring (changes to the item content only). A secondary aim of this study is to conduct a comprehensive implementation evaluation with key stakeholders during the recruitment period for the classification accuracy study using mixed methods. Following the administration of the MoCA and SCIP, all participants (N=350) will complete a brief self-report survey (i.e., two surveys per participant) which will collect data regarding the initial acceptability of the MoCA and SCIP (e.g., “Did you like/dislike the MoCA?”, “How much effort did it take to do the SCIP?”). To further explore the key perspectives about the acceptability, feasibility, and appropriateness of cognitive screening and identify the facilitators and barriers to implementation in FEP settings, a subset of young people with FEP (n=10-30) will be invited to participate in an interview or focus group to share their experiences of cognitive screening. This interview/focus group is likely to occur a within 3 months after completing the MoCA and SCIP. We will also invite other stakeholders in FEP treatment settings (i.e., clinicians, caregivers, service leaders) to participate in separate interview or focus groups as part of a comprehensive implementation evaluation.

The primary aim of this study is to validate a cognitive screening tool for young people with first-episode psychosis (FEP). We aim to evaluate the classification accuracy (relative to a neuropsychological assessment reference standard) and test-retest reliability of two cognitive screening tools in young people with FEP: the Screen for Cognitive Impairment in Psychiatry (SCIP) and Montreal Cognitive Assessment (MoCA). All participants (N=200) will complete both cognitive screening measures (MoCA and SCIP), neurodevelopment assessment, psychiatric assessment, and other supplementary measures (e.g., other clinical measures and acceptability questionnaires). The assessments will be separated into two days: day 1) cognitive screening tests and psychiatric and developmental assessment, and day 2) full neuropsychological assessment. Day 1 and Day 2 are estimated to take 3-4 hours each. The self-report measures will be split across both days to reduce participant burden, and will either be completed in person or the participant may choose to complete these measures at home. The assessments on each day will be completed by separate members of the research team, ideally conducted within seven days of each other. The assessment will be completed by a trained research assistant and will be administered under the remote supervision of a clinical neuropsychologist. The cognitive screening measures, neurodevelopmental and psychiatric assessments, and full neuropsychological assessment will likely occur at each of the participating sites (e.g., Orygen Specialist Program, Headspace) or at a location in the community (e.g., local library). The self-report supplementary measures will be completed in person or the participant may choose to receive a link to complete these measures at home. Test-retest assessment time-point (N=120) The SCIP and MoCA will be re-administrated to a sample of 120 people who completed the classification accuracy component of the study after two weeks (T2). Version 1 of the MoCA and SCIP will be administered to 60 consecutive participants and Version 2 to 60 consecutive participants for the retest reliability part of this study to determine the role of practice effects in the test-retest analysis. Both Version 1 and Version 2 of the MoCA and SCIP are validated measures and follow the same structure and scoring (changes to the item content only). A secondary aim of this study is to conduct a comprehensive implementation evaluation with key stakeholders during the recruitment period for the classification accuracy study using mixed methods. Following the administration of the MoCA and SCIP, all participants (N=200) will complete a brief self-report survey (i.e., two surveys per participant) which will collect data regarding the initial acceptability of the MoCA and SCIP (e.g., “Did you like/dislike the MoCA?”, “How much effort did it take to do the SCIP?”). To further explore the key perspectives about the acceptability, feasibility, and appropriateness of cognitive screening and identify the facilitators and barriers to implementation in FEP settings, a subset of young people with FEP (n=10-30) will be invited to participate in an interview or focus group to share their experiences of cognitive screening. This interview/focus group is likely to occur a within 3 months after completing the MoCA and SCIP. We will also invite other stakeholders in FEP treatment settings (i.e., clinicians, caregivers, service leaders) to participate in separate interview or focus groups as part of a comprehensive implementation evaluation.