Using Online Screening in the General Population to Detect Participants at Clinical High-Risk for Psychosis
Using Online Screening in the General Population to Detect Participants at Clinical High-Risk for Psychosis
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DOI：
10.1093/schbul/sby069
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发表时间：
2019-05-01
影响因子：
6.6
通讯作者：
Uhlhaas, Peter J.
中科院分区：
文献类型：
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作者：
McDonald, Mhairi;Christoforidou, Eleni;Uhlhaas, Peter J.
前言：确定精神病发展的临床高危(CHR)参与者是当前精神卫生研究中预防努力的一个重要目标。然而，在人口层面使用基于网络的筛查方法来检测慢性阻塞性肺病参与者的效用尚未得到调查。方法：我们测试了一种基于网络的筛查方法来识别CHR个体。通过电子邮件邀请、传单和邀请函邀请潜在参与者访问一个涉及普通人群和心理健康服务的网站。2,279名受试者完成了16个项目的前驱问卷(PQ-16)和9个项目的知觉和认知异常问卷(PCA)，用于在线评估基本症状(BS)。52.3%的参与者符合PQ的先验截止标准，73.6%的参与者符合在线PCA项目的先验截止标准。1,787名受试者被邀请进行临床访谈，采用危险心理状态综合评定量表(CAARMS)和精神分裂症倾向成人版访谈(SPI-A)进行访谈，应答率为19.9%。检测到101名CHR参与者和8名首发精神病(FEP)患者。ROC曲线分析显示，根据UHR和BS标准的在线结果，预测CHR状态的敏感性和特异性为良好至中等(敏感性/特异性：PQ-16=82%~146%；PCA=94%/12%)。从PQ-16和PCA中选择10个项目的子集导致特异度提高57%，而敏感度只有轻微影响(81%)。CHR参与者的功能和神经认知缺陷水平与临床确定的CHR组相似。结论：这些数据为通过基于人群的网络筛查确定慢性阻塞性肺疾病参与者的可能性提供了证据。这可能是对精神障碍进行早期干预和诊断的重要策略。
Introduction: Identification of participants at clinical high-risk (CHR) for the development of psychosis is an important objective of current preventive efforts in mental health research. However, the utility of using web-based screening approaches to detect CHR participants at the population level has not been investigated. Methods: We tested a web-based screening approach to identify CHR individuals. Potential participants were invited to a website via e-mail invitations, flyers, and invitation letters involving both the general population and mental health services. Two thousand two hundred seventy-nine participants completed the 16-item version of the prodromal questionnaire (PQ-16) and a 9-item questionnaire of perceptual and cognitive aberrations (PCA) for the assessment of basic symptoms (BS) online. 52.3% of participants met a priori cut-off criteria for the PQ and 73.6% for PCA items online. One thousand seven hundred eighty-seven participants were invited for a clinical interview and n = 356 interviews were conducted (response rate: 19.9%) using the Comprehensive Assessment of At-Risk Mental State (CAARMS) and the Schizophrenia Proneness Interview, Adult Version (SPI-A). n = 101 CHR participants and n = 8 first-episode psychosis (FEP) were detected. ROC curve analysis revealed good to moderate sensitivity and specificity for predicting CHR status based on online results for both UHR and BS criteria (sensitivity/specificity: PQ-16 = 82%146%; PCA = 94%/12%). Selection of a subset of 10 items from both PQ-16 and PCA lead to an improved of specificity of 57% while only marginally affecting sensitivity (81%). CHR participants were characterized by similar levels of functioning and neurocognitive deficits as clinically identified CHR groups. Conclusion: These data provide evidence for the possibility to identify CHR participants through population-based web screening. This could be an important strategy for early intervention and diagnosis of psychotic disorders.