Département de Psychiatrie, Université de Montréal Montréal, QC, Canada.
Front Psychiatry. 2013 Apr 18;4:25. doi: 10.3389/fpsyt.2013.00025. eCollection 2013.
Over the last 15 years, researchers from around the world have developed instruments for assessing the risk of conversion to psychosis. The objective of this article is to review the literature on these instruments by focusing on genealogy links and on their performance in predicting conversion to psychosis.
A systematic review of articles published since 1980 relating to risk assessment instruments for conversion to psychosis by manual search and consultation of electronic databases MEDLINE, EMBASE, and PsycINFO.
Three hundred ninety one (391) publications were selected and analyzed. Among these, 22 instruments were identified. These instruments are briefly described and placed on a timeline according to their year of publication. A code of positions, patterns, and forms is used to schematize the characteristics of each instrument. A table is presented to show changes in rates of conversion to psychosis within cohorts of subjects considered at risk according to the instruments. A second code of shades and outlines is used to schematize the characteristics of each cohort of patients. The two graphics set the stage for a discussion about the major strategies that were adopted to improve the performance of risk assessment instruments.
These graphics allow a better understanding of the origin, evolution, current status, strengths, shortcomings, and future prospects of research on risk assessment instruments. Clinical ImplicationsThe integration of theoretical approaches, the multicenter studies, and the pre-selection of patients with short questionnaires were the main strategies to improve the performance of instruments assessing the risk of conversion to psychosis.These instruments are better at predicting conversion to psychosis than conventional variables within a more limited time span and can therefore enable the evaluation of various risk factors and biomarkers that may be associated with psychosis. LimitationsThe studies selected for this review of literature were not classified according to their methodological quality.These studies are based on heterogeneous populations and this must be taken into account when comparing the rates of conversion to psychosis.This review of literature was based on published data only and they were no direct communication with the authors of these instruments.
在过去的 15 年中，来自世界各地的研究人员开发了用于评估向精神病转化风险的工具。本文的目的是通过关注谱系联系和预测向精神病转化的性能来回顾这些工具的文献。
通过手动搜索和查询 MEDLINE、EMBASE 和 PsycINFO 电子数据库，对 1980 年以来发表的与精神病转化风险评估工具相关的文章进行系统回顾。
共选择并分析了 391 篇文章。其中确定了 22 种工具。简要描述了这些工具，并根据其发布年份放置在时间线上。使用位置、模式和形式代码来示意每个工具的特征。展示了根据工具考虑处于风险中的受试者队列中向精神病转化的比率的变化。使用阴影和轮廓代码来示意每个患者队列的特征。这两个图形为讨论改善风险评估工具性能所采用的主要策略奠定了基础。
这些图形有助于更好地理解风险评估工具研究的起源、演变、现状、优势、缺点和未来前景。临床意义：理论方法的整合、多中心研究和短问卷患者的预选是提高评估向精神病转化风险的工具性能的主要策略。这些工具比传统变量更能预测向精神病的转化，因此可以评估可能与精神病相关的各种风险因素和生物标志物。局限性：本文对文献的回顾选择的研究未根据其方法学质量进行分类。这些研究基于异质人群，在比较向精神病转化的比率时必须考虑这一点。本文献综述仅基于已发表的数据，并未与这些工具的作者进行直接沟通。
