Nelson Barnaby, Simmons Magenta B, Yung Alison R, Buckby Joe A, O'Dwyer Lisa, Francey Shona M, Leicester Steven, Bapat Swagata, McGorry Patrick D
ORYGEN Research Centre, Parkville, Vic., Australia.
Aust N Z J Psychiatry. 2008 Mar;42(3):236-43. doi: 10.1080/00048670701827630.
Recent years have witnessed widespread interest in the early phase of psychotic disorders. The most widely used approach to identify individuals in the prodromal phase is the ultra-high risk (UHR) approach, which combines known trait and state risk factors for psychotic disorder. The Personal Assessment and Crisis Evaluation Clinic introduced the Comprehensive Assessment of At Risk Mental States (CAARMS) in order to assess UHR status. A training DVD and manual in the use of the CAARMS was recently developed in order to assist with UHR identification. The current paper reports the outcome of a series of training workshops with mental health professionals based around this DVD. The research aim was to investigate whether the training workshops assisted mental health professionals in their confidence and ability to accurately identify UHR cases and distinguish these from non-UHR and first-episode psychosis (FEP) cases.
A total of 137 mental health workers participated in the training sessions across eight training sites. The training sessions consisted of four modules: theoretical background; rating written vignettes for UHR, non-UHR or FEP status; viewing and discussing the CAARMS Training DVD; and re-rating matched written vignettes for UHR, non-UHR or FEP status.
Participants' confidence in identifying UHR cases and in using the CAARMS increased as a result of the workshop. Participants' ability to correctly identify UHR-positive cases did not improve as a result of the workshop. This may have been the result of a ceiling effect due to the baseline ability to identify UHR-positive cases being high. But there was a trend for participants' ability to correctly identify UHR-negative cases to improve as a result of the workshop.
UHR training workshops are a valuable means of increasing mental health workers' confidence in identifying UHR patients. Future UHR training programmes with experienced mental health professionals should pay particular attention to the correct identification of UHR-negative cases.
近年来，人们对精神障碍的早期阶段产生了广泛兴趣。识别前驱期个体最广泛使用的方法是超高风险（UHR）方法，该方法结合了已知的精神障碍特质和状态风险因素。个人评估与危机评估诊所引入了高危精神状态综合评估（CAARMS）来评估UHR状态。最近开发了一个关于使用CAARMS的培训DVD和手册，以协助进行UHR识别。本文报告了围绕该DVD开展的一系列针对心理健康专业人员的培训工作坊的结果。研究目的是调查这些培训工作坊是否有助于心理健康专业人员增强准确识别UHR病例并将其与非UHR及首发精神病（FEP）病例区分开来的信心和能力。
共有137名心理健康工作者在八个培训地点参加了培训课程。培训课程包括四个模块：理论背景；对UHR、非UHR或FEP状态的书面 vignette进行评分；观看并讨论CAARMS培训DVD；以及对匹配的书面vignette重新进行UHR、非UHR或FEP状态评分。
由于工作坊，参与者识别UHR病例和使用CAARMS的信心有所增强。工作坊并未提高参与者正确识别UHR阳性病例的能力。这可能是由于识别UHR阳性病例的基线能力较高而产生的天花板效应所致。但有一个趋势是，工作坊使参与者正确识别UHR阴性病例的能力有所提高。
UHR培训工作坊是增强心理健康工作者识别UHR患者信心的宝贵手段。未来针对经验丰富的心理健康专业人员的UHR培训计划应特别关注UHR阴性病例的正确识别。
