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World J Clin Cases. Mar 16, 2022; 10(8): 2420-2428
Published online Mar 16, 2022. doi: 10.12998/wjcc.v10.i8.2420
Identification and predictive analysis for participants at ultra-high risk of psychosis: A comparison of three psychometric diagnostic interviews
Peng Wang, Chuan-Dong Yan, Xiao-Jie Dong, Lei Geng, Chao Xu, Yun Nie, Sheng Zhang
Peng Wang, Chuan-Dong Yan, Xiao-Jie Dong, Lei Geng, Chao Xu, Yun Nie, Sheng Zhang, Department of Psychological Rehabilitation, the Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan 430022, Hubei Province, China
Author contributions: Wang P designed the research; Dong XJ, Geng L, Nie Y, and Xu C helped to collect the patient’s clinical data; Yan CD and Zhang S analyzed the data; Wang P and Zhang S wrote the paper and revised the manuscript; all authors read and approved the final manuscript.
Supported by the Health Commission of Hubei Province Scientific Research Project, No. WJ2019M016.
Institutional review board statement: The study was approved by the Ethics Committee of Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology (No. ky2018.45).
Clinical trial registration statement: This study is registered at ClinicalTrials.gov, registration number NCT05042739 (https://clinicaltrials.gov/ct2/show/NCT05042739).
Informed consent statement: Informed written consent was obtained from the patients for publication of this study.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sheng Zhang, MD, Associate Chief Physician, Department of Psychological Rehabilitation, the Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, No. 70 Youyi Road, Qiaokou District, Wuhan 430022, Hubei Province, China. 11024070@qq.com
Received: September 29, 2021
Peer-review started: September 29, 2021
First decision: December 2, 2021
Revised: December 14, 2021
Accepted: January 22, 2022
Article in press: January 22, 2022
Published online: March 16, 2022
Processing time: 162 Days and 20.5 Hours
Abstract
BACKGROUND

An accurate identification of individuals at ultra-high risk (UHR) based on psychometric tools to prospectively identify psychosis as early as possible is required for indicated preventive intervention. The diagnostic comparability of several psychometric tools, including the comprehensive assessment of at risk mental state (CAARMS), the structured interview for psychosis-risk syndrome (SIPS) and the bonn scale for the assessment of basic symptoms (BSABS), is unknown.

AIM

To address the psychometric comparability of CAARMS, SIPS and BSABS for subjects who are close relatives of patients with schizophrenia.

METHODS

In total, 189 participants aged 18-58 years who were lineal relative by blood and collateral relatives by blood up to the third degree of kinship of patients with schizophrenia were interviewed in the period of May 2017 to January 2019. Relatives of the participants diagnosed schizophrenia were excluded. All the participants were assessed for a UHR state by three psychometric tools (CAARMS, SIPS and BSABS). The psychometric diagnosis results included at risk of psychosis (UHR+), not at risk of psychosis (UHR-) and psychosis. Demographic and clinical characteristics were also measured. The inter-rater agreement was assessed for evaluation of the coherence of the three scales. Transition rates for UHR+ subjects to psychosis within 2 years were also recorded.

RESULTS

The overall agreement percentages were 93.12%, 92.06% and 93.65% of CAARMS and SIPS, SIPS and BSABS and CAARMS and BSABS, respectively. The overall agreement percentage of the relative functional impairment of the three groups (UHR+, not at risk of psychosis and psychosis) were 89.24%, 86.36% and 88.12%, respectively. The inter-rater reliability of the CAARMS, SIPS and BSABS total score was 0.90, 0.89 and 0.85. The inter-rater reliability was very good to excellent for all the subscales of these three instruments. For CAARMS, SIPS and BSABS, the kappa coefficient about UHR criteria agreement was 0.87, 0.84 and 0.82, respectively (P < 0.001). The transition rates of UHR+ to psychosis within 2 years were 16.7% (CAARMS), 10.0% (SIPS) and 17.7% (BSABS).

CONCLUSION

There is good diagnostic agreement between the CAARMS, SIPS and BSABS towards identification of UHR participants who are close relatives of patients with schizophrenia.

Keywords: Psychosis; Ultra-high risk; Psychosis-Risk syndrome; Psychometric diagnostic; Predictive analysis

Core Tip: To address the psychometric comparability of the comprehensive assessment of at risk mental state, Structured Interview for Psychosis-Risk Syndrome and Bonn Scale for the Assessment of Basic Symptoms for the assessment of participants who were lineal relative or collateral relatives by blood up to three generations of patients with schizophrenia, 189 participants were interviewed for an ultra-high risk state. The final conclusion was that there is good diagnostic agreement among these three instruments. Also, these three instruments may assess and detect at-risk mental states in these participants reliably and validly.