People with psychosis often experience cognitive difficulties—such as problems with memory, attention, processing speed, or executive functions—that directly affect their daily lives, from maintaining employment to managing personal autonomy or social relationships. Despite their importance, assessing these abilities quickly and accurately in clinical practice is not always possible.
In this context, a multicenter project led by the Marqués de Valdecilla Research Institute (IDIVAL) and coordinated by Dr. Rosa Ayesa Arriola has achieved a major breakthrough. The study, titled “Adaptation and Validation of the Brief Assessment of Cognition App (BAC App) and the Virtual Reality Assessment of Functional Capacity Tool (VRFCAT) for Use in Spain”, was funded by the 2020 call of the Strategic Health Action (ISCIII) and involved researchers from 15 CIBERSAM groups across public hospitals and research centers throughout Spain.
The article, recently published in European Psychiatry, validates for the first time in the Spanish population the use of these tablet-based tools, allowing for a brief—about 30 minutes—automated evaluation of six key cognitive domains.
Broad Participation and Collaboration
Initially, 30 researchers from 13 CIBERSAM groups participated, including teams from IDIVAL and the Cantabrian Health Service. Two additional centers later joined to reach the planned sample size. In total, more than 400 individuals were recruited: 117 with first-episode psychosis, 125 with schizophrenia, and 160 healthy controls.
The study demonstrated that the BAC App distinguishes patients from controls with high accuracy (AUC = 0.86) and that its performance is associated with IQ, functional capacity, and symptom severity. It was also confirmed that sociodemographic factors influence outcomes, leading to the development of specific percentile tables.
The success of this article is largely due to the thorough data analysis and manuscript preparation by the first author, Dr. César González-Blanch Bosch, as well as the extraordinary recruitment efforts of all participating researchers, who overcame numerous challenges. Although the project officially began in January 2021, the first participant was not evaluated until July 2022 due to COVID-19-related circumstances. The scale of the study—with patients and controls recruited across 15 hospitals and mental health centers over more than two years—reflects the commitment and coordination of numerous clinical and research teams. Without this collective effort, it would not have been possible to achieve the level of evidence now presented.
Clinical Relevance and Next Steps
Until now, the BAC App had not been validated nor had normative data in the Spanish population. Its availability paves the way for more accessible, rapid, and standardized cognitive assessment, reducing the need for specialized staff and facilitating its incorporation into routine clinical practice. This tool will enable professionals to detect and monitor cognitive difficulties early, design personalized interventions, and objectively evaluate treatment response—ultimately improving the prognosis and quality of life for patients and their families.
Following this first validation, the next objectives are to assess functionality through virtual reality tasks, test the application in other contexts, and expand the normative databases. Research is also underway to explore its remote use and application in non-clinical settings, which could enable continuous and less intrusive follow-up.
