Mapping the Onset of Psychosis: The Comprehensive Assessment of At-Risk Mental States
By A. Yung, Hok Pan Yuen, Patrick D. McGorry, Lisa J. Phillips, D. Kelly, M. Dell'olio, S. Francey, E. Cosgrave, E. Killackey, C. Stanford and 2 more. Australian and New Zealand journal of psychiatry (Print), 2005
2,187 citations recorded by the source corpus.
Objective: Recognizing the prodrome of a first psychotic episode prospectively creates the opportunity of intervention, which could delay, ameliorate or even prevent onset. Valid criteria and a reliable methodology for identifying possible prodromes are needed. This paper describes an instrument, the Comprehensive Assessment of At-Risk Mental States (CAARMS), which has been designed for such a purpose. It has two functions: (i) to assess psychopathology thought to indicate imminent development of a first-episode psychotic disorder; and (ii) to determine if an individual meets criteria for being at ultra high risk (UHR) for onset of first psychotic disorder. This paper describes the pilot evaluation of the CAARMS. Method: Several methodologies were used to test the CAARMS. First, CAARMS scores in a group of UHR young people and the association between CAARMS scores and the risk of transition to psychotic disorder, were analysed. Second, CAARMS scores in a UHR group were compared to a control group. To assess concurrent validity, CAARMS-defined UHR criteria were compared to the existing criteria for identifying the UHR cohort. To assess predictive validity, the CAARMS-defined UHR criteria were applied to a sample of 150 non-psychotic help-seekers and rates of onset of psychotic disorder at 6-month follow-up determined for the CAARMS-positive (i.e. met UHR criteria) group and the CAARMS-negative (i.e. did not meet UHR criteria) group. The inter-rater reliability of the CAARMS was assessed by using pairs of raters. Results: High CAARMS score in the UHR group was significantly associated with onset of psychotic disorder. The control group had significantly lower CAARMS scores than the UHR group. The UHR criteria assessed by the CAARMS identified a similar group to the criteria measured by existing methodology. In the sample of non-psychotic help-seekers those who were CAARMS-positive were at significantly increased risk of onset of psychotic disorder compared to those who were CAARMS-negative (relative risk of 12.44 (95% CI=1.5–103.41, p=0.0025)). The CAARMS had good to excellent reliability. Conclusions: In these preliminary investigations, the CAARMS displayed good to excellent concurrent, discriminant and predictive validity and excellent inter-rater reliability. The CAARMS instrument provides a useful platform for monitoring sub threshold psychotic symptoms for worsening into full-threshold psychotic disorder.
Subfields: Clinical Psychology, Psychiatry and Mental health
View Paper: https://www.semanticscholar.org/paper/81a59525451cb83a24f9e2827b6aa823bb65f462
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Citations in the corpus
- Using deep learning to investigate the neuroimaging correlates of psychiatric and neurological disorders: Methods and applications (2017, neutral): “In ddition, despite the evidence that psychosis, similar to AD, is preeded by a prodromal stage (Yung et al., 2005), there have been o studies applying DL to neuroimaging data to classify individuls at high risk of developing psychosis from healthy controls or istinguishing between high risk individ”
- Elevated striatal dopamine function linked to prodromal signs of schizophrenia. (2009, background): “The onset of schizophrenia is usually preceded by a prodromal phase characterized by functional decline and subtle prodromal symptoms, which include attenuated psychotic phenomena and a decline in socio-occupational function.(15) Individuals with these features have what has been termed an at-risk m”
- The social determinants of mental health and disorder: evidence, prevention and recommendations (2024, background): “These biases may be compounded by the instruments used to identify high risk individuals, which are often developed 394,401 and tested 402 in unrepresentative, helpseeking samples.”
- Prediction of psychosis in youth at high clinical risk: a multisite longitudinal study in North America. (2008, methodology): “…of prodromal psychosis, 15,16 a conversion rate of 35% was observed among 104 clinical high-risk subjects identified using criteria comparable to the SIPS, 16 and a conversion rate of 49% was observed (after 9.6 years of follow-up) among 110 cases identified using the Bonn Scale of Basic Symptoms.”