Krebs M-O, Magaud E, Willard D, Elkhazen C, Chauchot F, Gut A, Morvan Y, Bourdel M-C, Kazes M
Service hospitalo-universitaire S14, faculté de médecine Paris-Descartes, université Paris-Descartes, centre hospitalier Sainte-Anne, 75014 Paris, France; Inserm, laboratoire de physiopathologie de maladies psychiatriques, université Paris-Descartes, PRES Paris-Sorbonne-Cité, centre de psychiatrie et neurosciences, UMR894, GDR 3557 psychiatrie, 75014 Paris, France.
Service hospitalo-universitaire S14, faculté de médecine Paris-Descartes, université Paris-Descartes, centre hospitalier Sainte-Anne, 75014 Paris, France; Inserm, laboratoire de physiopathologie de maladies psychiatriques, université Paris-Descartes, PRES Paris-Sorbonne-Cité, centre de psychiatrie et neurosciences, UMR894, GDR 3557 psychiatrie, 75014 Paris, France.
Encephale. 2014 Dec;40(6):447-56. doi: 10.1016/j.encep.2013.12.003. Epub 2014 Aug 12.
This article aims to present the validation study of the French version of the Comprehensive Assessment of at risk mental states (CAARMS), an interview that seeks to determine whether young adults criteria for at-risk (AR) mental states, or psychosis. We assessed 40 young subjects, 15 were considered as "prodromal" (Prd) and 10 as experiencing a first episode of psychosis (PEP) by our expert clinician at the center - centre d'évaluation des jeunes adultes et adolescents, University Hospital Centre, Paris - and 15 were healthy controls matched for age and sex. When assessed with the CAARMS, 73 % (n=11) of the prodromal subjects reached the criteria for AR mental state, four subjects did not reach the criteria for AR, nor psychosis (P) and 100 % of the PEP reached the criteria for P. The three groups were significantly different on CAARMS total score (P<0.001) and subscores ; Prd subjects had intermediate scores between PEP (P<0.001) and controls (P<0.001) scores, PEP showing the highest scores. Post-hoc analysis showed that Prd significantly differed from Controls on each subscale (P<0.001) and that Prd differed from PEP on the "positive symptoms" subscale (P<0.001), as well as on "behavioural change" (P=0.021), owing to difference on the item "impaired role function". We used the brief psychiatric rating scale 24 items with anchor (BPRS24-EA) in addition to with the CAARMS, the AR group showed intermediate scores between controls and P subjects. Total scores of both scales were correlated (r=0.408 ; P=0.043) and the BPRS24-EA "positive symptoms" score was correlated with CAARMS' scores on the "Positive symptoms" subscale (r=0.456, P=0.022), "emotional disturbance" (r=0.506, P=0.01), and "behavioural change" (r=0.666 P=0.001). We found no correlation between BPRS negative and depression subscales and any of the CAARMS' subscales. When looking at its reliability, reliability coefficients (Cronbach's alpha) showed excellent reliability for "positive symptoms", "emotional disturbance", "behavioural change" and "general psychopathology" (respectively r=0.82, 0.75, 0.78, 0.84, 0.83) and moderate reliability for "cognitive change", "negative symptoms" and "motor/physical change" (respectively r=0.39, 0.59, 0.43). Overall, analysis of the results of construct validity, concurrent validity and reliability of the CAARMS indicates that the French version is valid and reliable. It is now available to develop and implement early detection programs in French speaking countries.
本文旨在介绍法语版高危精神状态综合评估(CAARMS)的验证研究,这是一项旨在确定年轻成年人是否符合高危(AR)精神状态或精神病标准的访谈。我们评估了40名年轻受试者,其中15名被我们中心(巴黎大学医院中心青少年及青年成人评估中心)的专家临床医生认定为“前驱期”(Prd),10名正经历首次精神病发作(PEP),另外15名是年龄和性别匹配的健康对照。使用CAARMS进行评估时,73%(n = 11)的前驱期受试者达到了AR精神状态标准,4名受试者未达到AR标准,也未达到精神病(P)标准,100%的PEP受试者达到了P标准。三组在CAARMS总分(P<0.001)和子分数上有显著差异;Prd受试者的分数介于PEP(P<0.001)和对照(P<0.001)分数之间,PEP的分数最高。事后分析表明,Prd在每个子量表上与对照组均有显著差异(P<0.001),且Prd在“阳性症状”子量表(P<0.001)以及“行为改变”方面(P = 0.021)与PEP存在差异,这是由于“角色功能受损”这一项目上的差异所致。除了CAARMS外,我们还使用了带锚点的24项简明精神病评定量表(BPRS24 - EA),AR组的分数介于对照组和P组受试者之间。两个量表的总分具有相关性(r = 0.408;P = 0.043),BPRS24 - EA的“阳性症状”分数与CAARMS“阳性症状”子量表的分数相关(r = 0.456,P = 0.022)、与“情绪障碍”相关(r = 0.506,P = 0.01)以及与“行为改变”相关(r = 0.666,P = 0.001)。我们发现BPRS的阴性和抑郁子量表与任何CAARMS子量表之间均无相关性。在考察其信度时,信度系数(克朗巴哈系数)显示“阳性症状”“情绪障碍”“行为改变”和“一般精神病理学”具有出色的信度(分别为r = 0.82、0.75、0.78、0.84、0.83),而“认知改变”“阴性症状”和“运动/身体改变”具有中等信度(分别为r = 0.39、0.59、0.43)。总体而言,对CAARMS的结构效度、同时效度和信度结果的分析表明,法语版是有效且可靠的。现在它可用于在法语国家开展和实施早期检测项目。