1/3 Community Psychosis Risk Screening: An Instrument Development Study

项目摘要/摘要 这项拟议的研究旨在开发一份简短、有效的筛查问卷，以确定有风险的个人 3个不同人口的大型社区集水区的非临床人群中的精神病。 这是一项必要的研究，因为目前对高危精神病患者人群的筛查工具只有 在临床和/或寻求治疗的样本中进行验证，这些样本可能不会在这些之外推广 专用设置。拟议的项目将管理3个著名的精神病风险筛查人员，以及 基于其他症状(例如，抑郁、焦虑等)和基于风险因素的调查问卷(例如大麻 和其他药物使用、重大精神障碍家族史、精神创伤史)增加到6,000人 3个人口统计不同地点的当地社区的青少年/年轻人(费城， 巴尔的摩和大芝加哥地区)。根据三种精神病的既定分界值 筛查者，1560名受试者被认为是风险较高的问卷(n=780；QHR)，而调查问卷被认为风险较低 (n=780；QLR)精神病患者(根据试点数据估计样本量)将被邀请完成半 结构化访谈，以确定精神状态的临床高危(CHR)基于结构化 面谈精神病风险综合征(SIPS)并评估当前/过去的主要精神障碍 DSM-5(SCID-5)的结构化临床访谈。根据初步数据和保守估计， 我们预计QHR组中的117人将被认为是精神错乱的慢性阻塞性肺疾病。具体目标如下 以下是：1)确定3个地区的弱化阳性精神病症状的正常值和患病率 多样化的社区集水区和2)开发问卷筛选器，使用基于症状的 以及基于风险因素的问卷，根据sips进行验证，以确定chr的精神病患者。 在社区里。这是美国第一项确定阈值以下精神病症状比率的研究 跨不同的非求助样本，这对于使用维度方法进行调查是必不可少的 到精神错乱。此外，拟议的研究将开发一种基本的筛查工具，以确定 哪些人最需要在CHR研究或临床中进行结构化访谈 用于确定精神病风险状态的设置。这个工具将是非常有价值的，因为研究结果表明， 发展成精神障碍的人通常直到精神障碍发作后才寻求治疗，而且持续时间 未经治疗的精神病的发生率与更严重的临床结果有关。拟议中的研究具有潜在的 对精神障碍的早期发现和预防做出重大贡献。

Project Summary/Abstract The proposed study aims to develop a brief, valid screening questionnaire to identify individuals at risk for psychosis in non-clinical populations across 3 large, community catchment areas with diverse populations. This is a needed study, as the current screening tools for at-risk psychotic populations have only been validated in clinical and/or treatment seeking samples, which likely do not generalize outside of these specialized settings. The proposed project will administer 3 well-known psychosis risk screeners, as well as additional symptom-based (e.g., depression, anxiety, etc.) and risk-factor based questionnaires (e.g., cannabis and other substance use, a family history of major mental disorders, trauma history) to 6,000 adolescents/young adults in local communities across 3 demographically diverse sites (Philadelphia, Baltimore, and the greater Chicago areas). Based on established cut-off scores from the 3 psychosis screeners, 1,560 subjects deemed as questionnaire higher risk (n=780; QHR) and questionnaire lower risk (n=780; QLR) for psychosis (estimated sample sizes based on pilot data) will be invited to complete semi- structured interviews to determine clinical high risk (CHR) for psychosis status based on the Structured Interview for Psychosis-Risk Syndromes (SIPS) and to assess current/past major mental disorders based on the Structured Clinical Interview for DSM-5 (SCID-5). Based on preliminary data and conservative estimates, we anticipate that 117 of the QHR group will be considered CHR for psychosis. The specific aims are as follows: 1) to determine norms and prevalence rates of attenuated positive psychotic symptoms across 3 diverse, community catchment areas and 2) to develop a questionnaire screener, using both symptom-based and risk factor-based questionnaires, that is validated against the SIPS to identify those at CHR for psychosis in the community. This is the first study in the U.S. to determine the rate of subthreshold psychotic symptoms across diverse non-help seeking samples, which is essential for investigations using dimensional approaches to psychotic disorders. Further, the proposed study will develop an essential screening tool that will identify which individuals have the greatest need for follow-up with structured interviews in CHR studies or clinical settings to determine psychosis-risk status. This tool is will be quite valuable given findings that those who develop psychotic disorders often do not seek treatment until after the onset of the disorder, and that duration of untreated psychosis is associated with more serious clinical outcomes. The proposed study has the potential for major contributions to the early detection and prevention of psychotic disorders.