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

项目概要/摘要 这项拟议的研究旨在开发一个简短，有效的筛选问卷，以确定个人的风险， 在3个大型社区集水区的非临床人群中，不同人群的精神病。 这是一项必要的研究，因为目前对高危精神病人群的筛查工具仅限于 在临床和/或寻求治疗的样本中得到验证，这些样本可能不会在这些样本之外推广。 专门的设置。拟议的项目将管理3个著名的精神病风险筛查，以及 附加的基于MEMS的（例如，抑郁、焦虑等）和基于风险因素的问卷（例如，大麻 及其他物质使用、重大精神障碍家族史、创伤史）至6000人 3个人口统计学上不同的地点（费城， 巴尔的摩和更大的芝加哥地区）。基于3种精神病的既定临界评分 筛选者中，1，560例受试者被视为问卷较高风险（n = 780; QHR）和问卷较低风险 （n = 780; QLR）精神病（基于初步数据估计的样本量）将被邀请完成半 结构化访谈，以根据结构化访谈确定精神病状态的临床高风险（CRD） 精神病风险综合征（SIPS）访谈，并根据以下因素评估当前/过去的主要精神障碍 DSM-5结构化临床访谈（SCID-5）。根据初步数据和保守估计， 我们预计QHR组中有117人将被视为精神病患者。具体目标如下： 以下：1）确定3个年龄组中减弱的阳性精神病性症状的常模和患病率， 多样化的社区集水区，2）开发一个问卷筛选器，使用基于 和基于风险因素的问卷，这是验证了对SIPS，以确定那些在精神病治疗 在社区这是美国第一项确定阈下精神病症状发生率的研究。 在不同的非求助样本中，这对于使用维度方法的调查至关重要 精神障碍此外，拟议的研究将开发一种基本的筛选工具， 哪些人最需要在临床研究或临床研究中进行结构化访谈 以确定精神病风险状态。这一工具将是相当有价值的调查结果，那些谁 发展为精神障碍的人往往直到疾病发作后才寻求治疗， 未经治疗的精神病与更严重的临床结果相关。这项研究有可能 对早期发现和预防精神障碍做出了重大贡献。

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.