Scalable Digital Phenotyping of Momentary Cognition in Early Course Psychosis

This proposal seeks to transform the assessment of cognition in psychosis through utilizing smartphones to capture momentary cognition and employing this data to create clinically actionable metrics, new targets for interventions, and novel biomarkers for mechanistic research. Today rapid and scalable cognitive assessments are not accessible for use in routine care and thus cognitive deficits, the single greatest cause of functional impairment in psychosis, remain understudied and under-treated. This proposal seeks to return a focus toward cognition through innovation in scalable, data-driven, high-dimensional, intensive longitudinal methods using smartphone digital phenotyping. Leveraging our already deployed teams in both the U.S and India combined with an already developed smartphone platform used at all sites, this proposal is designed to focus on rapid innovation and clinical results. Building off promising pilot data that demonstrate clear feasibility, we propose to create a smartphone specific suite of cognitive assessments designed to capture those domains most important in first-episode psychosis, validate its use against gold-standard measures, and explore new personalized models of cognition that can account for individual sleep and activity patterns - creating a more holistic and clinically actionable profile of each person’s cognition as it evolves across time and environments.