Lejuste F, Pedron L, Bonnard E, Urban M, Morvan Y, Urben S, Gaillard R, Conus P, Krebs M-O
GHU psychiatrie et neuroscience, Sainte-Anne, France.
GHU psychiatrie et neuroscience, Sainte-Anne, France; Inserm, laboratoire de physiopathologie des maladies psychiatriques, IPNP, U1266, université de Paris, institut de psychiatrie (CNRS GDR 3557), Paris, France.
Encephale. 2021 Dec;47(6):547-553. doi: 10.1016/j.encep.2020.11.009. Epub 2021 Apr 15.
The duration of untreated psychosis has been largely associated with poor outcomes in psychosis. Actual diagnostic tools may be used by very specialized teams and need sustained evaluation. We present a French version of a self-report questionnaire: the 16-item Prodromal Questionnaire (fPQ16). Our objective was to evaluate its predictive value for an ultra-high-risk state (UHR) or psychosis. The population enrolled was consulting in a young adults and adolescents center in Sainte-Anne hospital, Paris, France.
PQ16 had first been translated into French and independently back translated and validated by the original authors. Between November 2016 and May 2018, every C'JAAD consulting patient was proposed to fill in the fPQ16. Each patient was next evaluated with the French version of the comprehensive assessment of at-risk mental state (CAARMS), which detects UHR or psychosis. Statistical analysis of fPQ16 concurrent validity was performed using ROC curves. fPQ16 acceptability was studied by four additional questions especially designed for that purpose.
One hundred participants were included. Mean age was 19.85years (SD 3.3 y). Fifty-eight percent of patients included were diagnosed with UHR (40%) or psychotic (18%) state after CAARMS evaluation. Mean score at fPQ16 was 5.7 (SD 3.8). Best cut-off score was 4 positive items, with excellent sensibility (91%) and correct specificity (60%). Positive predictive value of fPQ16 was 76%. Area under the curve was 0.85 (P<0.0001). fPQ16 showed good acceptability.
fPQ16 had good screening performances in our population. Cut-off score was lower than in previous studies, but performances were equal or better. As a well-accepted and short questionnaire, the fPQ16 could be a great screening tool in primary care. A version with 18-items, including two items focused on thought content and disorganization that are missing in PQ16, is under evaluation.
未治疗的精神病持续时间在很大程度上与精神病的不良预后相关。实际的诊断工具可能只有非常专业的团队才能使用，并且需要持续评估。我们展示了一份自我报告问卷的法语版本：16项前驱症状问卷（fPQ16）。我们的目的是评估其对超高风险状态（UHR）或精神病的预测价值。研究对象为在法国巴黎圣安妮医院的青少年和青年中心就诊的患者。
PQ16首先被翻译成法语，然后由原作者独立进行回译和验证。在2016年11月至2018年5月期间，建议每一位在C'JAAD就诊的患者填写fPQ16。接下来，使用检测UHR或精神病的法国版高危精神状态综合评估量表（CAARMS）对每位患者进行评估。使用ROC曲线对fPQ16的同时效度进行统计分析。通过专门为此设计的另外四个问题来研究fPQ16的可接受性。
纳入了100名参与者。平均年龄为19.85岁（标准差3.3岁）。在CAARMS评估后，58%的纳入患者被诊断为UHR（40%）或精神病状态（18%）。fPQ16的平均得分为5.7（标准差3.8）。最佳截断分数为4个阳性项目，具有出色的敏感性（91%）和正确的特异性（60%）。fPQ16的阳性预测值为76%。曲线下面积为0.85（P<0.0001）。fPQ16显示出良好的可接受性。
fPQ16在我们的研究人群中具有良好的筛查性能。截断分数低于先前的研究，但性能相同或更好。作为一份广受欢迎的简短问卷，fPQ16可能是初级保健中的一种优秀筛查工具。一个包含18个项目的版本正在评估中，其中包括PQ16中缺失的两个关注思维内容和紊乱的项目。
