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评估自我报告的临床高风险症状:前驱期问卷-简明版的波兰文版本的心理测量学特性和一种替代评分方法的建议。

Assessing self-reported clinical high risk symptoms: The psychometric properties of the polish version of the prodromal questionnaire-brief and a proposal for an alternative approach to scoring.

机构信息

Independent Clinical Psychology Unit, Department of Psychiatry, Pomeranian Medical University in Szczecin, Szczecin, Poland.

Institute of Psychology, SWPS University of Social Sciences and Humanities, Wrocław, Poland.

出版信息

Early Interv Psychiatry. 2021 Oct;15(5):1059-1071. doi: 10.1111/eip.13035. Epub 2020 Sep 6.

Abstract

BACKGROUND

Psychotic-like experiences (PLEs) might occur in the general population as low-risk individual differences or prodromal features, requiring quick detection and early intervention. The aims of this study were to conduct a mini-systematic review of the prognostic abilities of the Prodromal Questionnaire-Brief (PQ-B), describe the PLEs distribution for the first time in a Polish population, assess PQ-B reliability and propose an innovative scoring approach based on cluster analysis.

METHODS

Five hundred and twenty eight (334 female) adult volunteers underwent screening with the PQ-B, 49% also underwent the early psychosis screening test PRIME, to verify the tests' psychometric properties, to compare the prognostic accuracy of the PQ-B to the more restrictive PRIME, and to the detected types of possible diagnosis in the general population.

RESULTS

Almost 70% of respondents met the prognostic criteria of the PQ-B while only 30.6% met the PRIME criteria. Both tests proved reliable (α > .835) and valid (rho >.710; P < .001). A cluster analysis identified three different sub-groups detected with the PQ-B: healthy individuals without PLE; healthy with low-distressing PLEs; and possibly prodromal subjects reporting less frequent but more distressing PLEs and no worries about their own mental state. Also in systematic reviews, authors of different adaptations have observed that the PQ-B has too low specificity and postulated the need for higher cut-offs.

CONCLUSION

Study provides evidence of good reliability and sensitivity of the PQ-B in assessing PLEs among the general population, but emphasizes that straightforward quantitative scoring criteria are still unclear. A more qualitative approach might be useful for differentiating true prodromal subjects from clinically low-risk individual differences.

摘要

背景

精神病样体验(PLEs)可能在普通人群中作为低风险的个体差异或前驱特征出现,需要快速检测和早期干预。本研究的目的是对前驱期问卷-简短版(PQ-B)的预后能力进行小型系统评价,首次描述波兰人群中 PLEs 的分布,评估 PQ-B 的可靠性,并提出一种基于聚类分析的创新评分方法。

方法

528 名(334 名女性)成年志愿者接受了 PQ-B 的筛查,其中 49%还接受了早期精神病筛查测试 PRIME,以验证测试的心理测量特性,比较 PQ-B 与更严格的 PRIME 的预后准确性,并与普通人群中可能的诊断类型进行比较。

结果

近 70%的受访者符合 PQ-B 的预后标准,而只有 30.6%符合 PRIME 标准。两种测试均具有可靠性(α>0.835)和有效性(rho>0.710;P<0.001)。聚类分析确定了 PQ-B 检测到的三个不同亚组:无 PLE 的健康个体;PLE 较少但困扰较大且对自身精神状态无担忧的低危健康个体;以及可能的前驱期个体。不同改编版本的作者在系统评价中也观察到,PQ-B 的特异性太低,并假设需要更高的截止值。

结论

研究提供了 PQ-B 在评估普通人群中 PLEs 方面具有良好可靠性和敏感性的证据,但强调简单的定量评分标准仍不明确。更定性的方法可能有助于区分真正的前驱期个体与临床低风险的个体差异。

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