The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA; Hofstra Northwell School of Medicine, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA; The Feinstein Institute for Medical Research, Manhasset, NY, USA.
The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA.
J Affect Disord. 2019 Apr 15;249:357-365. doi: 10.1016/j.jad.2019.02.040. Epub 2019 Feb 12.
There is no standard method for assessing symptoms of the prodrome to bipolar disorder (BD), which has limited progress toward early identification and intervention. We aimed to validate the Bipolar Prodrome Symptom Scale-Abbreviated Screen for Patients (BPSS-AS-P), a brief self-report derived from the validated, clinician-rated Bipolar Prodrome Symptom Interview and Scale-Full Prospective (BPSS-FP), as a means to screen and identify people for whom further evaluation is indicated.
Altogether, 134 participants (aged 12-18 years) were drawn from a study of the pre-syndromal stage of mood and psychotic disorders. All participants had chart diagnoses of a mood- or psychosis-spectrum disorder. Participants were interviewed with the BPSS-FP and completed measures of mania and non-mood psychopathology. Prior to being interviewed, patients completed the BPSS-AS-P. Scores on the BPSS-AS-P were determined by summing the severity and frequency ratings for each item.
BPSS-AS-P scores were highly reliable (Cronbach's alpha = 0.94) and correlated with the interview-based BPSS-FP Mania Symptom Index (r = 0.55, p < .0001). BPSS-AS-P scores had good convergent validity, correlating with the General Behavior Inventory-10M (r = 0.65, p < .0001) and Young Mania Rating Scale; r = 0.48, p < .0001). The BPSS-AS-P had good discriminant validity, not being correlated with scales measuring positive and negative symptoms of psychotic disorders (p-values = 0.072-0.667).
Findings are limited by the cross-sectional nature of the study by the fact that the participants were all treatment-seeking. Future studies need to evaluate the predictive validity of the BPSS-AS-P for identifying those who develop BD in a community sample.
BPSS-AS-P has promise as a screening tool for people at risk for BD. Adopting the BPSS-AS-P would support the goal of characterizing the prodrome systematically in order to facilitate research and clinical care.
目前尚缺乏评估双相障碍（BD）前驱症状的标准方法，这限制了早期识别和干预的进展。我们旨在验证从经过验证的、临床医生评定的双相障碍前驱症状访谈和量表-全面前瞻性（BPSS-FP）衍生而来的简短自评量表——双相障碍前驱症状量表-患者简明筛查版（BPSS-AS-P），作为一种筛查和识别需要进一步评估的人的方法。
共有 134 名（年龄 12-18 岁）参与者来自心境和精神病前驱阶段的研究。所有参与者均有心境或精神病谱系障碍的图表诊断。参与者接受 BPSS-FP 访谈，并完成了躁狂和非心境精神病学的测量。在接受访谈之前，患者完成了 BPSS-AS-P。BPSS-AS-P 的分数通过对每个项目的严重程度和频率评分进行求和来确定。
BPSS-AS-P 得分具有高度可靠性（克朗巴赫系数 = 0.94），与基于访谈的 BPSS-FP 躁狂症状指数相关（r = 0.55，p<0.0001）。BPSS-AS-P 得分具有良好的聚合效度，与一般行为量表-10M（r = 0.65，p<0.0001）和 Young 躁狂评定量表相关（r = 0.48，p<0.0001）。BPSS-AS-P 具有良好的区分效度，与测量精神病性障碍阳性和阴性症状的量表不相关（p 值为 0.072-0.667）。
研究结果受到研究的横断面性质的限制，以及参与者均为治疗寻求者的事实。未来的研究需要评估 BPSS-AS-P 对识别社区样本中发生 BD 的人的预测效度。
BPSS-AS-P 有望成为 BD 风险人群的筛查工具。采用 BPSS-AS-P 将有助于系统地描述前驱期，以促进研究和临床护理。
