Kline Emily, Thompson Elizabeth, Demro Caroline, Bussell Kristin, Reeves Gloria, Schiffman Jason
Dr. Kline is with the Department of Psychiatry, Harvard Medical School, and Beth Israel Deaconess Medical Center, Boston (e-mail:
Psychiatr Serv. 2016 Apr 1;67(4):456-9. doi: 10.1176/appi.ps.201500063. Epub 2015 Nov 16.
Practice guidelines emphasize frequent clinical monitoring of patients at high risk for psychosis. No brief instrument assessing attenuated psychotic symptoms has been validated for this purpose. This study examined use of three self-report questionnaires, which were developed as psychosis risk screeners, for monitoring symptom severity in a naturalistic clinical sample of 54 adolescents.
Self-report measures (Prime Screen-Revised, Prodromal Questionnaire-Brief Version [PQ-B], and Youth Psychosis At-Risk Questionnaire-Brief) and clinician assessments (Structured Interview for Psychosis Risk Syndromes) were administered to participants at baseline and six months.
Changes in self-report scores were moderately correlated with changes in clinician ratings. The PQ-B demonstrated slightly better agreement with changes in clinician ratings than the other two measures.
Questionnaires developed as psychosis risk screeners could be used for symptom monitoring. Further validation of tools to monitor attenuated symptoms will be a valuable step toward developing an evidence-based approach for treating high-risk youths.
实践指南强调对有精神病高风险的患者进行频繁的临床监测。目前尚无用于此目的的评估精神病性症状减弱的简短工具得到验证。本研究考察了三种作为精神病风险筛查工具开发的自陈问卷在一个由54名青少年组成的自然临床样本中监测症状严重程度的情况。
在基线和六个月时，对参与者进行自陈测量（修订版初筛量表、简短版前驱症状问卷[PQ-B]和简短版青少年精神病风险问卷）以及临床医生评估（精神病风险综合征结构化访谈）。
自陈分数的变化与临床医生评分的变化呈中度相关。与其他两项测量相比，PQ-B与临床医生评分变化的一致性略好。
作为精神病风险筛查工具开发的问卷可用于症状监测。进一步验证监测症状减弱的工具将是朝着为治疗高风险青少年制定循证方法迈出的重要一步。
