Yared Mahlet, Kim Hannah H, Ametaj Amantia, Alemayehu Melkam, Stevenson Anne, Milkias Barkot, Girma Engida, Gelaye Bizu, Teferra Solomon
Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.
Early Interv Psychiatry. 2025 Jan;19(1):e13609. doi: 10.1111/eip.13609. Epub 2024 Sep 2.
Few psychosis screening instruments have been tested for use in Africa, yet appropriate tools can increase the detection of self-reported psychotic symptoms, improve the detection of psychosis and impact its prognosis.
The construct validity and factor structure of Psychosis Screening Questionnaire (PSQ) were tested with confirmatory factor analysis (CFA) and item response theory (IRT) in a sample of 1928 Ethiopian adults without any history of psychosis. We tested a unidimensional model with and without an item on mania. For IRT, unidimensional latent structure one-parameter logistic (1PL) and two-parameter (2PL) logistic models were tested and compared for relative fit using a likelihood-ratio test.
The prevalence of lifetime positive screens was 2.8% in an Ethiopian sample of adults from a general medical setting. A unidimensional model demonstrated good fit for the PSQ, (CFI = 0.993, TLI = 0.986 and RMSEA = 0.025). For IRT, a 2PL model was the best fitting one. IRT tests of item difficulty and discrimination parameters showed that paranoia had the highest discrimination and lowest difficulty ( ), likely to be endorsed at low levels of psychotic features. Thought insertion had the highest item difficulty ( ). Overall, the measure captures the psychosis construct at higher levels of the latent trait and may be suited for detecting moderate to severe levels of psychosis.
The PSQ is found to have good construct validity in screening for psychosis among Ethiopian adults. Future studies may focus on the diagnostic validity of the PSQ comparing it with a structured clinical interview.
很少有精神病筛查工具在非洲进行过测试，但合适的工具可以增加对自我报告的精神病症状的检测，提高精神病的检出率并影响其预后。
在1928名无精神病病史的埃塞俄比亚成年人样本中，采用验证性因素分析（CFA）和项目反应理论（IRT）对精神病筛查问卷（PSQ）的结构效度和因素结构进行测试。我们测试了一个有和没有关于躁狂症项目的单维模型。对于IRT，测试了单维潜在结构单参数逻辑（1PL）和双参数（2PL）逻辑模型，并使用似然比检验比较了相对拟合度。
在埃塞俄比亚一个普通医疗环境中的成年人样本中，终生阳性筛查的患病率为2.8%。一个单维模型显示对PSQ拟合良好（CFI = 0.993，TLI = 0.986，RMSEA = 0.025）。对于IRT，2PL模型是拟合最好的。项目难度和区分参数的IRT测试表明，偏执具有最高的区分度和最低的难度（ ），在低水平的精神病特征下可能被认可。思维插入具有最高的项目难度（ ）。总体而言该测量方法在潜在特质的较高水平上捕捉到了精神病结构，可能适合检测中度至重度精神病。
发现PSQ在埃塞俄比亚成年人精神病筛查中具有良好的结构效度。未来的研究可以将重点放在将PSQ与结构化临床访谈进行比较的诊断效度上。
