Longitudinal and cross-sectional validation of the WERCAP screen for assessing psychosis risk and conversion.
Longitudinal and cross-sectional validation of the WERCAP screen for assessing psychosis risk and conversion.
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DOI：
10.1016/j.schres.2022.01.031
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发表时间：
2022-03
影响因子：
4.5
通讯作者：
Ndetei, David M.
中科院分区：
文献类型：
--
作者：
Mamah, Daniel;Mutiso, Victoria N.;Ndetei, David M.
华盛顿早期识别中心情感和精神病筛查（WERCAP）旨在评估精神病的风险。它的有效性尚未在一个大的人口为基础的研究或纵向分析。从肯尼亚招募了825名14-25岁的参与者。使用WERCAP筛选评估症状，如前3个月（3 MO）、12个月（12 MO）或终生（LIF）经历的症状。ROC曲线分析用于确定WERCAP筛查对精神病风险综合征结构化访谈的有效性。通过比较精神病性障碍转换者和非转换者的基线p-WERCAP评分，并使用ROC曲线分析来评估纵向效度。检查p-WERCAP与临床变量的关系。针对SIPS的ROC曲线分析显示，3 MO的AUC为0.83，12 MO为0.79，LIF精神病评分为0.65。3 MO的最佳临界点为>12分（sens：0.78; spec：0.77; ppv：0.41），12 MO的最佳临界点为>32分（sens：0.71; spec：0.74; ppv：0.24）。转换者的基线3 MO评分（但不是LIF评分）高于高风险非转换者（p = 0.02）。针对转化状态的3 MO评分具有0.75的AUC，最佳截止点>16（sens：1.0; spec：0.53）。所有p-WERCAP评分均与物质使用和压力严重程度显著相关。12项MO评分与认知功能障碍最相关。WERCAP筛查是评估精神病严重程度和转换风险的有效工具。它可以在社区中用于确定那些可能需要临床评估和护理的人，并用于精神病风险研究的招募。
The Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen was developed to assess risk for developing psychosis. Its validity has not been investigated in a large population-based study or with longitudinal analyses. 825 participants, aged 14–25, were recruited from Kenya. Symptoms were assessed using the WERCAP Screen, as experienced over the prior 3-months (3MO), 12-months (12MO) or lifetime (LIF). ROC curve analysis was used to determine the validity of the WERCAP Screen against the Structured Interview of Psychosis-Risk Syndromes. Longitudinal validity was assessed by comparing baseline p-WERCAP scores in psychotic disorder converters and non-converters, and using ROC curve analysis. Relationship of the p-WERCAP was examined against clinical variables. ROC curve analyses against SIPS showed an AUC of 0.83 for 3MO, 0.79 for 12MO and 0.65 for LIF psychosis scores. The optimal cut-point on 3MO was a score of >12 (sens: 0.78; spec: 0.77; ppv: 0.41), and >32 for 12MO (sens: 0.71; spec: 0.74; ppv: 0.24). Baseline 3MO scores (but not LIF scores) were higher in converters compared to high-risk non-converters (p = 0.02). 3MO scores against conversion status had an AUC of 0.75, with an optimal cutoff point of >16 (sens: 1.0; spec: 0.53). All p-WERCAP scores significantly correlated with substance use and stress severity. 12 MO scores were most related to cognitive impairment. The WERCAP Screen is a valid instrument for assessing psychosis severity and conversion risk. It can be used in the community to identify those who may require clinical assessment and care, and for recruitment in psychosis-risk research.
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