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THE COGNITION
GAME STUDY
Anna Domen
Academic Medical
Center Amsterdam,
Psychiatry division
THE COGNITION
GAME STUDY
Improving cognition in
psychiatric patients
with an online
cognitive game and
assessment tool
COGNITIVE
PROBLEMS IN
PSYCHIATRIC
PATIENTS
VERY COMMON ACROSS DIFFERENT DIAGNOSES
Attention
Working
memory
Executive
Function
Episodic
memory
Processing
speed
Major depression +(+) ++ ++ ++ ++(+)
Schizophrenia +++ +++ +++ +++ ++
Autism Spectrum Disorder +++ + + ++ +++
ADHD +++ ++ ++ 0/+ ++
OCD +++ +(+) +(+) + ++
PTSD +++ +(+) +(+) ++ +
Panic disorder +++ + + + ++
Parkinson's disease ++ ++(+) ++(+) + +++
Alzheimer's disease +(+) +(+) +(+) +++ +
Millan et al. 2012
MAJOR INFLUENCE ON EVERYDAY FUNCTIONING
PERSISTENT EVEN DURING REMISSION
Darcet et al. 2016
WHAT DO WE EXPECT?
Improving
cognitive
functioning
in psychiatric
patients
Employment
and independent
living
Reduced
healthcare
and economic
burden
CURRENT STATE
OF AFFAIRS
COGNITIVE
REMEDIATION WORKS!
However,
 Not used much in
clinical practice
 Can be boring, leading
to drop-out
 Effects often do not
generalize to everyday
functioning
Meta-analysis
by Anaya et al. 2012
THE COGNITION
GAME STUDY
AQUASNAP
COGNITIVE GAME
 Online portal,
easily accessable
from home
 Enjoyable game
environment
 Adapts to the
player’s cognitive
level
MYCQ
 Configures AquaSnap
 Short (10 subtests, 30
minutes)
 Can be used at
home, no trained
assessor needed
 Assesses 5 cognitive
domains
DESIGN OF THE STUDY
 Subjects:
Patients with a diagnosis of:
- depression
- obsessive compulsive disorder
- schizophrenia / schizo-affective disorder
 Age: 16-55
DESIGN OF THE STUDY
Intervention group
 12 weeks of game
playing
 1-1,5 hours a week
 Assessed at baseline
and after 12 weeks
TAU (treatment as usual) group
 No cognitive training
 Assessed at baseline and
after 12 weeks
DESIGN OF THE STUDY
Validation of the
MyCQ
RESULTS
STRUCTURE OF THE MYCQ
MyCQ
Attention
SRT errors
CRT errors
GNG errors
Processing
speed
SRT latency
CRT latency
Memory VeMR errors
ViMR errros
Working
memory
VeMR latency
ViMR latency
NB2 latency
Executive
functions
NB1 errors
COD latency
TMA latency
TMB latency
CONVERGENT VALIDITY
r = .650
The MyCQ
 Measures 5 domains
and compares well to
CANTAB good validity
 Can be completed in 30
minutes
 Can be completed from
home
 Can be used across
disorders
Playing the
Cognition Game
RESULTS
AMOUNT OF TIME SPEND ON THE GAME
11%
46%18%
25%
never started
less than 6 hours
6 - 12 hours
more than 12
-0.4
-0.2
0.0
0.2
0.4
0.6
0 hours played 0-6 hours played >6 hours played
WORKING ATTENTION EXECUTIVE PSYCHOMOTOR VISUAL VERBAL
MEMORY FUNCTION SPEED MEMORY MEMORY
COGNITION DIFFERENCE SCORES
-2.0
-1.0
0.0
1.0
2.0
3.0
4.0
5.0
0 hours played 0-6 hours played >6 hours played
PSYCHOSOCIAL FUNCTIONING DIFFERENCE SCORE
TOTAL WORK / HOUSEHOLD SOCIAL PRIVATE FAMILY /
EDUCATION ACTIVITIES ACTIVITIES RELATIONSHIPS
The Cognition Game
 Could improve working
memory when played
enough
 Could haven an effect on
improving psychosocial
functioning
 Has adherence problems..
LIMITATIONS
 Compliance and dropout
 Sample size
 No active control-group
NEXT STEPS
 Who complies with the
treatment?
 Who improves?
 How to improve
engagement?
I would like to acknowledge and
thank my supervisors:
Prof Damiaan Denys
Dr Dorien Nieman
and co-authors:
Prof Monique Jaspers
Sjors van de Weijer, MSc
Thanks!
Any questions?
You can contact me met at

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Improving cognition in psychiatric patients with an online cognitive game and assessment tool