Utility of Washington Early Recognition Center Self-Report Screening Questionnaires in the Assessment of Patients with Schizophrenia and Bipolar Disorder.
Utility of Washington Early Recognition Center Self-Report Screening Questionnaires in the Assessment of Patients with Schizophrenia and Bipolar Disorder.
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DOI：
10.3389/fpsyt.2016.00149
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发表时间：
2016
影响因子：
4.7
通讯作者：
Mamah D
中科院分区：
文献类型：
--
作者：
Hsieh CJ;Godwin D;Mamah D
早期识别和治疗与双相情感障碍 (BPD) 和精神分裂症 (SCZ) 的预后改善相关。筛查这些疾病的存在通常需要进行耗时的访谈，这在心理健康服务提供者有限的环境中可能不切实际。因此，处于疾病早期阶段的个体通常无法被识别。华盛顿早期识别中心情感和精神病 (WERCAP) 筛查是一份自我报告问卷，最初开发用于识别患双相情感障碍或精神病的临床风险。当前研究的目的是调查 WERCAP 筛查和两个补充问卷（WERC 压力筛查和 WERC 物质筛查）在识别已确诊 SCZ 或 BPD 的个体中的效用。参与者包括 35 名 BPD 患者和 34 名 SCZ 患者，以及 32 名年龄 18-30 岁的对照者 (CON)。使用单变量分析来测试组间的得分差异。使用逻辑回归和受试者工作特征（ROC）曲线来确定诊断预测因子。 WERCAP 的精神病部分 (pWERCAP; p < 0.001)、WERCAP 的情感部分 (aWERCAP; p = 0.001) 和压力严重程度 (p = 0.027) 发现显着的组间差异。通过 WERC 物质筛查测量，物质使用率没有发现显着的组间差异 (p = 0.267)。只有 aWERCAP 和 pWERCAP 评分是诊断类别的有用预测因子。 ROC 曲线分析显示，aWERCAP 上识别参与者组中 BPD 的最佳切点是得分 >20 [曲线下面积 (AUC)：0.87；灵敏度：0.91；特异性：0.71]，而 pWERCAP 识别 SCZ 的得分 >13（AUC：0.89；敏感性：0.88；特异性：0.82）。这些结果表明，WERCAP 筛查可能有助于筛查个体的 BPD 和 SCZ，并且可以使用自我报告问卷快速识别压力和药物使用的严重程度。需要对未确诊的个体进行更大规模的研究，以测试 WERCAP 筛查识别社区中躁狂症或精神病的能力。
Early identification and treatment are associated with improved outcomes in bipolar disorder (BPD) and schizophrenia (SCZ). Screening for the presence of these disorders usually involves time-intensive interviews that may not be practical in settings where mental health providers are limited. Thus, individuals at earlier stages of illness are often not identified. The Washington Early Recognition Center Affectivity and Psychosis (WERCAP) screen is a self-report questionnaire originally developed to identify clinical risk for developing bipolar or psychotic disorders. The goal of the current study was to investigate the utility of the WERCAP Screen and two complementary questionnaires, the WERC Stress Screen and the WERC Substance Screen, in identifying individuals with established SCZ or BPD. Participants consisted of 35 BPD and 34 SCZ patients, as well as 32 controls (CON), aged 18–30 years. Univariate analyses were used to test for score differences between groups. Logistic regression and receiver operating characteristic (ROC) curves were used to identify diagnostic predictors. Significant group differences were found for the psychosis section of the WERCAP (pWERCAP; p < 0.001), affective section of the WERCAP (aWERCAP; p = 0.001), and stress severity (p = 0.027). No significant group differences were found in the rates of substance use as measured by the WERC Substance Screen (p = 0.267). Only the aWERCAP and pWERCAP scores were useful predictors of diagnostic category. ROC curve analysis showed the optimal cut point on the aWERCAP to identify BPD among our participant groups was a score of >20 [area under the curve (AUC): 0.87; sensitivity: 0.91; specificity: 0.71], while that for the pWERCAP to identify SCZ was a score of >13 (AUC: 0.89; sensitivity: 0.88; specificity: 0.82). These results indicate that the WERCAP Screen may be useful in screening individuals for BPD and SCZ and that identifying stress and substance-use severity can be rapidly done using self-report questionnaires. Larger studies in undiagnosed individuals will be needed to test the WERCAP Screen’s ability to identify mania or psychosis in the community.