Self-Reported Questionnaires for Attenuated Psychosis Symptoms Validated



Three short screening questionnaires that do not require specialized training to administer have been shown to be comparable in identifying female adolescents at risk of developing psychosis, according to a study published in Schizophrenia Research.

The Yale PRIME Screen–Revised, the Youth Psychosis at-Risk Questionnaire–Brief (YPARQ-B), and the Prodromal Questionnaire–Brief (PQ-B) each adequately provided a useful assessment for Attenuated Psychosis Syndrome (APS), when compared with the Structured Interview for Prodromal Risk Syndromes (SIPS).

Although past research has shown that the short screening tools were comparable to one another, "no study to date has examined the relations between several simultaneously administered screening measures and interview-based APS status in an effort to determine which measure relates most strongly to a ‘gold-standard,’ " reported Emily Kline and her associates at the University of Maryland in Baltimore (Schizophr. Res. 2012:141;72-7 [doi:10.1016/j.schres.2012.07.022]).

Having brief questionnaires to reliably screen for APS offers broader and more affordable screening options since SIPS requires more time and a trained practitioner to administer.

The researchers recruited 49 study participants (76% of whom were female) aged 12-22 years from community clinics and a psychiatric inpatient treatment unit and through advertisements. All participants were currently receiving mental health services and had a mean age of 16.72 years. The ethnically diverse group included black (43%), white (39%), Asian (2%), Native American (2%), and multiracial (12%) patients. A total of 2% did not report race, and 8% identified as Hispanic, reported Ms. Kline and her associates.

The participants filled out each of the three short screens before being interviewed by a trained health professional using SIPS. The screens were provided to participants in alternating order (Latin square design) to reduce the likelihood of bias from the order in which the screens were completed.

The results of the screenings were then analyzed against the diagnoses found from the SIPS to determine concurrence, with normality, outliers, and possible ordering effects taken into account. SIPS can lead to four diagnoses (present psychosis, psychosis risk syndromes, schizotypal personality disorder, and no evidence of psychosis/risk) and has previously accurately predicted psychoses within 2.5 years for 35% of those meeting psychosis risk syndrome criteria.

The authors reported that all three short screens provided valuable, reliable results related to psychosis risk. "Through analyses intended to parse the relative merits of the three measures, no single tool emerged as a clear front-runner," the authors reported. "The choice of which among the three instruments to use will likely depend on the assessors’ goals."

They noted that PRIME Screen was the easiest and quickest to administer and score, but the longer time required for the YPARQ-B paid off with the highest level of accuracy. PRIME Screen had 61% accuracy while YPARQ-B’s accuracy was 71% and PQ-B’s was 55%.

The authors noted that the findings may not be generalizable since the participants were young and predominantly female. The small sample size also may have led to underpowered test results; more than 200 participants would be required to detect clinically significant differences between the correlations, they reported.

The study was funded partly by a Research Seed Funding Initiative grant from the University of Maryland, Baltimore County, and by the University of Maryland division of child and adolescent psychiatry. The authors reported no disclosures.

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