Virtual reality assessment of daily life executive functions in mood disorders: associations with neuropsychological and functional measures

Background: Mood disorders are often accompanied by cognitive difficulties that impede patients' functional capacity. However, neuropsychological tests provide limited insight into patients' ability to tackle daily life cognitive challenges. To address this challenge, we investigated the sensitivity and validity of the Jansari assessment of Executive Functions (JEF(C)) virtual reality test in patients with mood disorders and its associations with functional capacity. Methods: In total, 21 patients with bipolar disorder or unipolar disorder in full or partial remission and 29 healthy control participants were recruited for the study. Participants attended one test session during which they underwent diagnostic assessments, mood ratings and assessments with JEF(C), a battery of standard neuropsychological tests (RAVLT, Trial Making A and B, Fluency tests, letter-number sequencing and RBANS digit span and coding tests) and functional capacity measures (UPSA-B and FAST). Results: Patients showed impaired executive functions on JEF(C) compared to the control group. Relative to the control group, patients were also impaired on neuropsychological sub-composite scores of executive function, verbal memory and processing speed as well as on a global cognition composite score. In addition, JEF(C) scores predicted performance on a global cognition composite based on neuropsychological tests, and a performance-based measure of functional capacity. Limitations: This study had a relatively small sample size and included a mixed group of patients with unipolar or bipolar disorder. Conclusions: JEF(C) is a sensitive and valid measure of daily life executive impairments in patients with mood disorders that is associated with functional capacity.