Fusar-Poli P, Cappucciati M, Rutigliano G, Lee T Y, Beverly Q, Bonoldi I, Lelli J, Kaar S J, Gago E, Rocchetti M, Patel R, Bhavsar V, Tognin S, Badger S, Calem M, Lim K, Kwon J S, Perez J, McGuire P
Institute of Psychiatry Psychology and Neuroscience (IoPPN), King's College London, London SE5 8AF, UK; OASIS Service, South London and Maudsley NHS Foundation Trust, London SE11, UK.
Institute of Psychiatry Psychology and Neuroscience (IoPPN), King's College London, London SE5 8AF, UK.
Psychiatry J. 2016;2016:7146341. doi: 10.1155/2016/7146341. Epub 2016 May 30.
Background. Several psychometric instruments are available for the diagnostic interview of subjects at ultra high risk (UHR) of psychosis. Their diagnostic comparability is unknown. Methods. All referrals to the OASIS (London) or CAMEO (Cambridgeshire) UHR services from May 13 to Dec 14 were interviewed for a UHR state using both the CAARMS 12/2006 and the SIPS 5.0. Percent overall agreement, kappa, the McNemar-Bowker χ (2) test, equipercentile methods, and residual analyses were used to investigate diagnostic outcomes and symptoms severity or frequency. A conversion algorithm (CONVERT) was validated in an independent UHR sample from the Seoul Youth Clinic (Seoul). Results. There was overall substantial CAARMS-versus-SIPS agreement in the identification of UHR subjects (n = 212, percent overall agreement = 86%; kappa = 0.781, 95% CI from 0.684 to 0.878; McNemar-Bowker test = 0.069), with the exception of the brief limited intermittent psychotic symptoms (BLIPS) subgroup. Equipercentile-linking table linked symptoms severity and frequency across the CAARMS and SIPS. The conversion algorithm was validated in 93 UHR subjects, showing excellent diagnostic accuracy (CAARMS to SIPS: ROC area 0.929; SIPS to CAARMS: ROC area 0.903). Conclusions. This study provides initial comparability data between CAARMS and SIPS and will inform ongoing multicentre studies and clinical guidelines for the UHR psychometric diagnostic interview.
背景。有几种心理测量工具可用于对超高危（UHR）精神病患者进行诊断访谈。它们的诊断可比性尚不清楚。方法。对2006年5月13日至12月14日转诊至OASIS（伦敦）或CAMEO（剑桥郡）UHR服务机构的所有患者，使用CAARMS 12/2006和SIPS 5.0对其UHR状态进行访谈。采用总体一致性百分比、kappa系数、McNemar - Bowker χ²检验、等百分位法和残差分析来研究诊断结果以及症状严重程度或频率。在来自首尔青年诊所（首尔）的独立UHR样本中验证了一种转换算法（CONVERT）。结果。在识别UHR患者方面，CAARMS与SIPS总体上有较高的一致性（n = 212，总体一致性百分比 = 86%；kappa = 0.781，95% CI为0.684至0.878；McNemar - Bowker检验 = 0.069），短暂有限间歇性精神病性症状（BLIPS）亚组除外。等百分位链接表将CAARMS和SIPS的症状严重程度和频率联系起来。在93名UHR患者中验证了转换算法，显示出极佳的诊断准确性（从CAARMS转换为SIPS：ROC曲线下面积为0.929；从SIPS转换为CAARMS：ROC曲线下面积为0.903）。结论。本研究提供了CAARMS和SIPS之间的初步可比性数据，并将为正在进行的多中心研究以及UHR心理测量诊断访谈的临床指南提供参考。
