Clinical Trials Study
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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
ARTICLE HIGHLIGHTS
Research background

Indicated preventive intervention is the new hope for affecting the psychosis progress since treatments for psychosis substantially improve outcomes. Therefore, an accurate identification of individuals at ultra-high risk (UHR) based on psychometric tools to prospectively identify psychosis as early as possible is required to allow preventative screening, diagnosis and interventions. With the development of psychiatry, psychometric tools have been created, analyzed and confirmed. There is little evidence of a single recognized standard among these instruments for UHR identification in China.

Research motivation

In total, 189 participants who were the lineal relative or collateral relatives by blood up to the third degree of kinship of schizophrenia patients were interviewed to identify a UHR state by three psychometric tools, including the comprehensive assessment of at-risk mental states (CAARMS), the Structured Interview for psychosis-risk syndrome (SIPS) and the bonn scale for the assessment of basic symptoms (BSABS), which are the most common instruments in China.

Research objectives

To address the psychometric comparability of the CAARMS, SIPS and BSABS for assessment of close relative of schizophrenia patients and to verify the viability and reliability of these three instruments for these participants.

Research methods

All of the participants were assessed for a UHR state by the CAARMS, SIPS and BSABS. The psychometric diagnosis results included at risk of psychosis, not at risk of psychosis and psychosis. Demographic and clinical characteristics were also measured. The inter-rater agreement was assessed for evaluation of the coherence of the three instruments. The transition rates of at risk of psychosis to psychosis within 2 years were also recorded.

Research results

The overall agreement percentages were 93.12% for CAARMS and SIPS, 92.06% for SIPS and BSABS and 93.65% for CAARMS and BSABS. Moreover, the inter-rater reliability of the CAARMS, SIPS and BSABS total score was 0.90, 0.89 and 0.85, respectively. For all the subscales of these three scales, the inter-rater reliability varied from very good to excellent. The transition rates of at risk of psychosis to psychosis within 2 years were about 16.7% (CAARMS), 10.0% (SIPS) and 17.7% (BSABS).

Research conclusions

It showed a good diagnostic agreement between the CAARMS, SIPS and BSABS in identification of UHR participants who are close relative of patients with schizophrenia. Also, these three instruments are reliable and valid tools for at-risk mental states assessment and detection in these participants.

Research perspectives

The lineal and collateral relatives by blood up to the third generations of schizophrenia patients are clinical high-risk participants. Early detection aids in initiation of preventive intervention and can provide substantially improved outcomes. A multicenter interview and follow-up of these participants by different instruments will provide more experience and value for clinical high-risk participants.