Using online-screening in the general population to detect participants at clinical high-risk for psychosis

McDonald, M., Christoforidou, E., Van Rijsbergen, N. , Gajwani, R., Gross, J. , Gumley, A. I. , Lawrie, S. M., Schwannauer, M., Schultze-Lutter, F. and Uhlhaas, P. (2019) Using online-screening in the general population to detect participants at clinical high-risk for psychosis. Schizophrenia Bulletin, 45(3), pp. 600-609. (doi:10.1093/schbul/sby069) (PMID:29889271) (PMCID:PMC6483579)

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Abstract

Introduction: Identification of participants at clinical high-risk (CHR) for the development of psychosis is an important objective of current preventive efforts in mental health research. However, the utility of using web-based screening approaches to detect CHR participants at the population level has not been investigated. Methods: We tested a web-based screening approach to identify CHR individuals. Potential participants were invited to a website via e-mail invitations, flyers, and invitation letters involving both the general population and mental health services. Two thousand two hundred seventy-nine participants completed the 16-item version of the prodromal questionnaire (PQ-16) and a 9-item questionnaire of perceptual and cognitive aberrations (PCA) for the assessment of basic symptoms (BS) online. 52.3% of participants met a priori cut-off criteria for the PQ and 73.6% for PCA items online. One thousand seven hundred eighty-seven participants were invited for a clinical interview and n = 356 interviews were conducted (response rate: 19.9%) using the Comprehensive Assessment of At-Risk Mental State (CAARMS) and the Schizophrenia Proneness Interview, Adult Version (SPI-A). n = 101 CHR participants and n = 8 first-episode psychosis (FEP) were detected. ROC curve analysis revealed good to moderate sensitivity and specificity for predicting CHR status based on online results for both UHR and BS criteria (sensitivity/specificity: PQ-16 = 82%/46%; PCA = 94%/12%). Selection of a subset of 10 items from both PQ-16 and PCA lead to an improved of specificity of 57% while only marginally affecting sensitivity (81%). CHR participants were characterized by similar levels of functioning and neurocognitive deficits as clinically identified CHR groups. Conclusion: These data provide evidence for the possibility to identify CHR participants through population-based web screening. This could be an important strategy for early intervention and diagnosis of psychotic disorders.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Uhlhaas, Professor Peter and Christoforidou, Miss Eleni and Gross, Professor Joachim and Gumley, Professor Andrew and Gajwani, Dr Ruchika and Van Rijsbergen, Dr Nicola
Authors: McDonald, M., Christoforidou, E., Van Rijsbergen, N., Gajwani, R., Gross, J., Gumley, A. I., Lawrie, S. M., Schwannauer, M., Schultze-Lutter, F., and Uhlhaas, P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > Institute of Neuroscience and Psychology
Journal Name:Schizophrenia Bulletin
Publisher:Oxford University Press
ISSN:0586-7614
ISSN (Online):1745-1701
Published Online:08 June 2018
Copyright Holders:Copyright © 2018 The Authors
First Published:First published in Schizophrenia Bulletin 45(3): 600-609
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
640691Using Magnetoencephalography to Investigate Aberrant Neural Synchrony in Prodromal Schizophrenia: A Translational Biomarker ApproachPeter UhlhaasMedical Research Council (MRC)MR/L011689/1RI NEUROSCIENCE & PSYCHOLOGY