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Savill M, Loewy RL, Niendam TA, Porteus AJ, Rosenthal A, Gobrial S, Meyer M, Bolden KA, Lesh TA, Ragland JD, Carter CS. The diagnostic accuracy of screening for psychosis spectrum disorders in behavioral health clinics integrated into primary care. Schizophr Res 2024; 266:190-196. [PMID: 38422889 PMCID: PMC11140870 DOI: 10.1016/j.schres.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 01/29/2024] [Accepted: 02/10/2024] [Indexed: 03/02/2024]
Abstract
Screening for psychosis spectrum disorders in primary care could improve early identification and reduce the duration of untreated psychosis. However, the accuracy of psychosis screening in this setting is unknown. To address this, we conducted a diagnostic accuracy study of screening for psychosis spectrum disorders in eight behavioral health services integrated into primary care clinics. Patients attending an integrated behavioral health appointment at their primary care clinic completed the Prodromal Questionnaire - Brief (PQ-B) immediately prior to their intake assessment. This was compared to a diagnostic phone interview based on the Structured Interview for Psychosis Risk Syndromes (SIPS). In total, 145 participants completed all study procedures, of which 100 screened positive and 45 negative at a provisional PQ-B threshold of ≥20. The PQ-B was moderately accurate at differentiating psychosis spectrum from no psychosis spectrum disorders; a PQ-B distress score of ≥27 had a sensitivity and specificity of 71.2 % and 57.0 % respectively. In total, 66 individuals (45.5 %) met criteria for a psychosis spectrum disorder and 24 (16.7 %) were diagnosed with full psychosis, indicating a high prevalence of psychosis in the sample. Overall, screening for psychosis spectrum disorders in an IBH primary care setting identified a relatively high number of individuals and may identify people that would otherwise be missed. The PQ-B performed slightly less well than in population-based screening in community mental health settings. However, the findings suggest this may represent an effective way to streamline the pathway between specialty early psychosis programs and primary care clinics for those in need.
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Affiliation(s)
- Mark Savill
- University of California, Davis, United States of America.
| | - Rachel L Loewy
- University of California, San Francisco, United States of America
| | - Tara A Niendam
- University of California, Davis, United States of America
| | | | - Adi Rosenthal
- University of California, Davis, United States of America
| | - Sarah Gobrial
- University of California, Davis, United States of America
| | - Monet Meyer
- University of California, Davis, United States of America
| | | | - Tyler A Lesh
- University of California, Davis, United States of America
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Jahrami H, Saif Z. Reliability generalization meta-analysis of the Prodromal Questionnaire-Brief (PQ-B): Implications for Asian psychiatry. Asian J Psychiatr 2023; 87:103694. [PMID: 37450980 DOI: 10.1016/j.ajp.2023.103694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Haitham Jahrami
- Government Hospitals/Ministry of Health, Manama, Bahrain; Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.
| | - Zahra Saif
- Government Hospitals/Ministry of Health, Manama, Bahrain.
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Lee TY, Jo HJ. Differential diagnosis and comorbid physical illness of schizophrenia. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2021. [DOI: 10.5124/jkma.2021.64.8.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Schizophrenia is a neurodevelopmental disorder that generally develops during adolescence or early adulthood. However, differentiating it from psychosis caused by a physical illness is difficult due to the phenotypebased diagnostic system. In this review, differential diagnosis of schizophrenia and the comorbid physical illnesses of patients with schizophrenia will be discussed.Current Concepts: Psychotic symptoms can be caused by various physical illnesses, and patients with schizophrenia have many physical comorbidities. Symptoms of psychosis can also be expressed by physical illness including brain tumors, encephalitis, temporal lobe epilepsy, autoimmune disease, and genetic disease. For the differential diagnosis of other physical illnesses that can cause psychosis, biological tests are essential. Depending on the cause, antipsychotics and treatment of physical diseases are required. In addition, patients with schizophrenia have many comorbid medical conditions such as obesity, diabetes, cardiovascular disease, but the diagnosis rate is low, and the mortality is higher than that of the general population due to untreated medical diseases.Discussion and Conclusion: The differential diagnoses of schizophrenia and physical illness causing psychosis are important. To decrease the high mortality of patients with schizophrenia, periodic physical condition examinations and mental status examinations should be conducted.
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Wu J, Long X, Liu F, Qi A, Chen Q, Guan X, Zhang Q, Yao Y, Shi J, Xie S, Yan W, Hu M, Yuan X, Tang J, Wu S, Zhang T, Wang J, Lu Z. Screening of the college students at clinical high risk for psychosis in China: a multicenter epidemiological study. BMC Psychiatry 2021; 21:253. [PMID: 34001048 PMCID: PMC8127262 DOI: 10.1186/s12888-021-03229-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 04/21/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND To investigate a 3-stage screening procedure and explore the clinical features of subjects at Clinical High Risk (CHR) for psychosis in a representative sample of Chinese college students. METHODS An epidemiological survey of the prevalence of the CHR syndrome in Chinese college students that was selected by stratified random sampling from Shanghai, Nanjing and Nanchang cities was done following a 3-stage procedure. Participants were initially screened with the Prodromal Questionnaire-brief version (PQ-B), and whose distress score of PQ-B exceeded 24 would be invited to a telephone assessment using the subscale for positive symptoms of the Scale of Prodromal Symptoms (SOPS)/Structured Interview for Prodromal Syndromes (SIPS). Lastly, participants who scored 3 or higher in any item of the subscale would be administered with the SIPS interview conducted by trained researchers to confirm the diagnosis of CHR syndrome. RESULTS Twenty-three thousand sixty-three college students completed the survey during September 2017 to October 2018. Seventy-two students were diagnosed as CHR subjects, and the detection rate in the total sample was 0.3%. The peak age range for the first diagnosis of CHR was 17 to 20 years. Thirteen and forty-six were set as the cutoff points of PQ-B total score and distress score to balance the greatest sensitivity and specificity. Binary logistic regression revealed that 8 items in PQ-B showed significant distinction for detecting CHR subjects. CONCLUSIONS The 3-stage screening method can be utilized in the detection of CHR subjects for psychosis in the general population, during which delusional ideas, perceptual abnormalities and suspiciousness deserve great attention.
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Affiliation(s)
- Jiaxin Wu
- grid.24516.340000000123704535Department of Psychiatry, Tongji Hospital of Tongji University, Tongji University School of Medicine, 389 Xincun Road, Shanghai, 200065 PR China ,grid.24516.340000000123704535Tongji University School of Medicine, Shanghai, 200092 PR China
| | - Xiangyun Long
- grid.24516.340000000123704535Department of Psychiatry, Tongji Hospital of Tongji University, Tongji University School of Medicine, 389 Xincun Road, Shanghai, 200065 PR China ,grid.24516.340000000123704535Tongji University School of Medicine, Shanghai, 200092 PR China
| | - Fei Liu
- grid.24516.340000000123704535Department of Psychiatry, Tongji Hospital of Tongji University, Tongji University School of Medicine, 389 Xincun Road, Shanghai, 200065 PR China
| | - Ansi Qi
- grid.24516.340000000123704535Department of Psychiatry, Tongji Hospital of Tongji University, Tongji University School of Medicine, 389 Xincun Road, Shanghai, 200065 PR China
| | - Qi Chen
- grid.24516.340000000123704535Department of Psychiatry, Tongji Hospital of Tongji University, Tongji University School of Medicine, 389 Xincun Road, Shanghai, 200065 PR China
| | - Xiaofeng Guan
- grid.24516.340000000123704535Department of Psychiatry, Tongji Hospital of Tongji University, Tongji University School of Medicine, 389 Xincun Road, Shanghai, 200065 PR China
| | - Qiong Zhang
- grid.24516.340000000123704535Department of Psychiatry, Tongji Hospital of Tongji University, Tongji University School of Medicine, 389 Xincun Road, Shanghai, 200065 PR China
| | - Yuhong Yao
- grid.24516.340000000123704535Tongji University School of Medicine, Shanghai, 200092 PR China
| | - Jingyu Shi
- grid.24516.340000000123704535Tongji University School of Medicine, Shanghai, 200092 PR China
| | - Shiping Xie
- grid.89957.3a0000 0000 9255 8984Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029 PR China
| | - Wei Yan
- grid.89957.3a0000 0000 9255 8984Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029 PR China
| | - Maorong Hu
- grid.412604.50000 0004 1758 4073Department of Psychiatry, The First Affiliated Hospital of Nanchang University, Nanchang, 330006 PR China
| | - Xin Yuan
- grid.412604.50000 0004 1758 4073Department of Psychiatry, The First Affiliated Hospital of Nanchang University, Nanchang, 330006 PR China
| | - Jun Tang
- grid.412604.50000 0004 1758 4073Department of Psychiatry, The First Affiliated Hospital of Nanchang University, Nanchang, 330006 PR China
| | - Siliang Wu
- grid.412604.50000 0004 1758 4073Department of Psychiatry, The First Affiliated Hospital of Nanchang University, Nanchang, 330006 PR China
| | - Tianhong Zhang
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030 PR China
| | - Jijun Wang
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030 PR China
| | - Zheng Lu
- Department of Psychiatry, Tongji Hospital of Tongji University, Tongji University School of Medicine, 389 Xincun Road, Shanghai, 200065, PR China. .,Tongji University School of Medicine, Shanghai, 200092, PR China.
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Howie C, Potter C, Shannon C, Davidson G, Mulholland C. Screening for the at-risk mental state in educational settings: A systematic review. Early Interv Psychiatry 2020; 14:643-654. [PMID: 31883215 DOI: 10.1111/eip.12926] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/10/2019] [Accepted: 12/14/2019] [Indexed: 12/20/2022]
Abstract
AIM The at-risk mental state (ARMS) allows clinicians to identify individuals who have an increased risk of developing psychosis. At present, most screening for psychosis-risk is carried out within help-seeking populations; however, screening within educational settings may allow clinicians to identify individuals at-risk earlier and to increase the rate of detection. This review aimed to examine screening for the ARMS in educational settings, with the key questions: what screening tools have been used in educational settings, can screening in educational settings detect individuals with ARMS, what threshold scores in screening tools indicate a positive screen in educational settings, are there comorbid mental health conditions associated with the ARMS in educational settings? METHODS Searches were carried out in PsycINFO, MEDLINE, EMBASE, Scopus and Web of Science and reference lists of included articles searched. Results were summarized using narrative synthesis. RESULTS Nine papers were included for narrative synthesis. A variety of screening tools have been used when screening for the ARMS in educational settings. The majority of studies have been conducted in schools. The prevalence of the ARMS reported in ranges from 1% to 8%. CONCLUSIONS The ARMS indicates the presence of distressing symptoms for which intervention may be beneficial. Screening programmes within educational settings may allow outreach for prodromal symptoms at an earlier stage than clinical settings currently provided for.
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Affiliation(s)
- Clare Howie
- School of Medicine, Queen's University Belfast, Belfast, UK
| | - Claire Potter
- School of Medicine, Queen's University Belfast, Belfast, UK
| | - Ciaran Shannon
- Holywell Hospital, Northern Health and Social Care Trust, Antrim, UK
| | - Gavin Davidson
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, UK
| | - Ciaran Mulholland
- School of Medicine, Queen's University Belfast, Belfast, UK.,Holywell Hospital, Northern Health and Social Care Trust, Antrim, UK
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Lee TY, Lee J, Lee HJ, Lee Y, Rhee SJ, Park DY, Paek MJ, Kim EY, Kim E, Roh S, Jung HY, Kim M, Kim SH, Han D, Ahn YM, Ha K, Kwon JS. Study Protocol for a Prospective Longitudinal Cohort Study to Identify Proteomic Predictors of Pluripotent Risk for Mental Illness: The Seoul Pluripotent Risk for Mental Illness Study. Front Psychiatry 2020; 11:340. [PMID: 32372992 PMCID: PMC7186772 DOI: 10.3389/fpsyt.2020.00340] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 04/03/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The Seoul Pluripotent Risk for Mental Illness (SPRIM) study was designed to identify predictors leading to mental illness in help-seeking individuals by securing sufficient statistical power through transdiagnostic approaches. The SPRIM study aims to examine the clinical characteristics of high-risk individuals for mental illness and to identify proteomic biomarkers that can predict the onset of mental illness. METHODS This paper describes the study protocol of the SPRIM study. We aim to recruit 150 participants who meet the criteria for high risk for major mental illness, 150 patients with major psychiatric disorders (schizophrenia, bipolar disorder, and major depressive disorder), and 50 matched healthy control subjects for 2 years. Clinical evaluations, self-report measures, and proteomic analyses will be implemented. The assessment points are at baseline, 6, 12, 18, and 24 months. CONCLUSIONS In the present study, we introduced the study protocol of the SPRIM study, which is the first prospective cohort study of transdiagnostic high-risk concepts using proteomic biomarkers. This study has a paradigm that encompasses various diseases without aiming at predicting and preventing the development of a specific mental illness in help-seeking individuals. The transdiagnostic high-risk concept could be extended to provide a perspective for people with various psychopathological tendencies below a threshold, such that they do not meet the existing diagnostic criteria of mental illnesses, to determine what may lead them to a specific disease and help identify appropriate preventative interventions.
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Affiliation(s)
- Tae Young Lee
- Department of Neuropsychiatry, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Junhee Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Hyun Ju Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Yunna Lee
- Department of Neuropsychiatry, Kosin University Gospel Hospital, Pusan, South Korea
| | - Sang Jin Rhee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Dong Yeon Park
- Department of Psychiatry, National Center for Mental Health, Seoul, South Korea
| | - Myung Jae Paek
- Department of Psychiatry, The Armed Forces Capital Hospital, Seongnam, South Korea
| | - Eun Young Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Euitae Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Sungwon Roh
- Department of Neuropsychiatry, Hanyang University Hospital, Seoul, South Korea
| | - Hee Yeon Jung
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Se Hyun Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Dohyun Han
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Kyooseob Ha
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Jun Soo Kwon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
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Kim SW, Kim JK, Han JH, Jhon M, Kim JW, Lee JY, Kim JM, Na HJ, Kang YS, Chung YC, Yoon JS. Validation of the Korean Version of the 15-Item Community Assessment of Psychic Experiences in a College Population. Psychiatry Investig 2020; 17:306-311. [PMID: 32200606 PMCID: PMC7176566 DOI: 10.30773/pi.2019.0215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 01/20/2020] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To investigate the reliability and validity of the Korean version of the Community Assessment of Psychic Experiences-15 item positive scale (CAPE-15) in college students. METHODS This study had two stages: initial screening with self-report questionnaires including the CAPE-15, and semi-structured interviews to investigate the instrument's diagnostic validity. The initial screening involved 1,749 college students. The modified Korean version of Prodromal Questionnaire-16 item (mKPQ-16) was also administered. The criteria for ultra-high risk (UHR) of psychosis in the Comprehensive Assessment of At-Risk Mental States (CAARMS) were the gold standard for diagnosis. RESULTS Twelve of the interviewed subjects met the CAARMS criteria for UHR of psychosis. The area under the receiver operating characteristic curve was highest (0.936) for the CAPE-15 distress score (p<0.001). The use of 6 as the cutoff for the CAPE-15 distress score resulted in the best balance of sensitivity (91.7%) and specificity (85.2%), with a favorable positive predictive value of 32.4%. The coefficients of correlation between the CAPE-15 and mKPQ-16 were significant. CONCLUSION The Korean version of the CAPE-15 is a good instrument for screening for psychosis risk in collegiate settings. The validation of this scale could contribute to the early identification of psychosis in the Korean community.
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Affiliation(s)
- Sung-Wan Kim
- Mindlink, Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea.,Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Gwangju Mental Health Commission, Gwangju, Republic of Korea
| | - Jae-Kyeong Kim
- Mindlink, Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea
| | - Ji Hun Han
- Mindlink, Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea
| | - Min Jhon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju-Wan Kim
- Mindlink, Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea.,Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju-Yeon Lee
- Mindlink, Gwangju Bukgu Community Mental Health Center, Gwangju, Republic of Korea.,Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Gwangju Mental Health Commission, Gwangju, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hyun Ju Na
- Department of Nursing, Dong Kang University, Gwangju, Republic of Korea
| | - Young-Shin Kang
- Department of Psychology, Chonnam National University, Gwangju, Republic of Korea
| | - Young-Chul Chung
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Jin-Sang Yoon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
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