Kobayashi Hiroyuki, Nemoto Takahiro, Koshikawa Hiroki, Osono Yasunori, Yamazawa Ryoko, Murakami Masaaki, Kashima Haruo, Mizuno Masafumi
Department of Neuropsychiatry, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-Ku, Tokyo 160-8582, Japan.
Schizophr Res. 2008 Dec;106(2-3):356-62. doi: 10.1016/j.schres.2008.08.018. Epub 2008 Sep 21.
Early intervention for psychosis requires an easy, useful assessment instrument to identify subjects with prodromal symptoms at an early stage. The aim of this study was to test the clinical validity of the PRIME Screen-Revised (PS-R), a 12-item self-reported instrument for prodromal symptoms of psychosis, by comparing the results for a non-clinical population with those for a clinical population.
The PS-R was administered to 1,024 subjects (496 students and 528 outpatients). Of the 528 patients, 115 were randomly recruited and tested using the Structured Interview for Prodromal Syndromes (SIPS) to determine the concordant validity of the PS-R. The predictive validity of the PS-R was measured by determining the transition rate to psychosis during a 6-month follow-up period.
The specificity and sensitivity of the PS-R, using the SIPS as a gold standard, were 0.74 and 1.00. The concordant validity of the PS-R against the SIPS was 0.43. The predictive validity of the PS-R and the SIPS, defined as the transition rate to psychosis, were 0.11 and 0.25, respectively. None of the patients with negative PS-R results developed psychosis.
Our findings showed that the PS-R was highly valid and that its usage is feasible in both general practice and clinical settings. This self-reported instrument represents a useful screening tool for alerting clinicians to subjects with psychotic prodromal symptoms.
精神病的早期干预需要一种简便、实用的评估工具，以便在早期识别有前驱症状的个体。本研究的目的是通过比较非临床人群和临床人群的结果，来测试PRIME筛查修订版（PS-R）的临床有效性，PS-R是一种用于精神病前驱症状的12项自我报告工具。
对1024名受试者（496名学生和528名门诊患者）进行了PS-R测试。在528名患者中，随机招募了115名，并使用前驱综合征结构化访谈（SIPS）进行测试，以确定PS-R的一致性效度。通过确定6个月随访期内发展为精神病的转化率来测量PS-R的预测效度。
以SIPS作为金标准，PS-R的特异性和敏感性分别为0.74和1.00。PS-R与SIPS的一致性效度为0.43。PS-R和SIPS的预测效度（定义为发展为精神病的转化率）分别为0.11和0.25。PS-R结果为阴性的患者均未发展为精神病。
我们的研究结果表明，PS-R具有很高的效度，并且在一般实践和临床环境中都可行。这种自我报告工具是一种有用的筛查工具，可提醒临床医生注意有精神病前驱症状的个体。
