Web-based cognitive screening in bipolar disorder: validation of the Internet-based Cognitive Assessment Tool in remote administration settings

Background: Cognitive impairments are prevalent during remission in bipolar disorder (BD), but existing cognitive screening tools are time- and resource-intensive. Digital, web-based options can facilitate detection and monitoring of these impairments across clinical and research settings. Methods: This cross-sectional study investigated psychometric properties of the Internet-based Cognitive Assessment Tool (ICAT) when self-administered in home-based settings. Newly diagnosed, remitted outpatients with BD and healthy controls (HC) underwent cognitive testing with the standard paper-pencil tool Screen for Cognitive Impairment in Psychiatry (SCIP) in-clinic and ICAT at-home as part of baseline assessments for an intervention trial (ClinicalTrials ID: 2021-000862-14). Results: Data were analyzed for 31 BD patients and 29 HC. We demonstrated a strong positive correlation between at-home ICAT and in-clinic SCIP total scores within patients with BD (r(29) = 0.66, p < .001), which survived subsyndromal mood symptoms adjustment (partial r(25) = 0.67, p < .001), indicating adequate concurrent validity. There was a moderate positive correlation between ICAT and SCIP total scores across the entire sample (r(54) = 0.56, p < .001) and between subtest scores (r = 0.29–0.61, ps ≤ .03), except the executive functions tasks (p = .1). BD patients exhibited no impaired performance compared to HC on ICAT or SCIP (ps ≥ .08). Conclusions: ICAT is a valid and feasible online tool for remote cognitive screening in remitted patients with BD. Web-based screening constitutes an accessible and efficient approach for implementing systematic cognitive screening in BD.