Universität zu Köln

Fusar-Poli, Paolo ORCID: 0000-0003-3582-6788, Cappucciati, Marco, Rutigliano, Grazia ORCID: 0000-0001-6014-5357, Schultze-Lutter, Frauke, Bonoldi, Ilaria, Borgwardt, Stefan ORCID: 0000-0002-5792-3987, Riecher-Roessler, Anita, Addington, Jean, Perkins, Diana, Woods, Scott W., Mcglashan, Thomas H., Lee, Jimmy ORCID: 0000-0002-7724-7445, Klosterkoetter, Joachim, Yung, Alison R. and Mcguire, Philip (2015). At risk or not at risk? A meta-analysis of the prognostic accuracy of psychometric interviews for psychosis prediction. World Psychiatry, 14 (3). S. 322 - 333. HOBOKEN: WILEY. ISSN 2051-5545

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Abstract

An accurate detection of individuals at clinical high risk (CHR) for psychosis is a prerequisite for effective preventive interventions. Several psychometric interviews are available, but their prognostic accuracy is unknown. We conducted a prognostic accuracy meta-analysis of psychometric interviews used to examine referrals to high risk services. The index test was an established CHR psychometric instrument used to identify subjects with and without CHR (CHR+ and CHR-). The reference index was psychosis onset over time in both CHR+ and CHR- subjects. Data were analyzed with MIDAS (STATA13). Area under the curve (AUC), summary receiver operating characteristic curves, quality assessment, likelihood ratios, Fagan's nomogram and probability modified plots were computed. Eleven independent studies were included, with a total of 2,519 help-seeking, predominately adult subjects (CHR+: N=1,359; CHR-: N=1,160) referred to high risk services. The mean follow-up duration was 38 months. The AUC was excellent (0.90; 95% CI: 0.87-0.93), and comparable to other tests in preventive medicine, suggesting clinical utility in subjects referred to high risk services. Meta-regression analyses revealed an effect for exposure to anti-psychotics and no effects for type of instrument, age, gender, follow-up time, sample size, quality assessment, proportion of CHR+ subjects in the total sample. Fagan's nomogram indicated a low positive predictive value (5.74%) in the general non-help-seeking population. Albeit the clear need to further improve prediction of psychosis, these findings support the use of psychometric prognostic interviews for CHR as clinical tools for an indicated prevention in subjects seeking help at high risk services worldwide.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Fusar-Poli, Paolo UNSPECIFIED orcid.org/0000-0003-3582-6788 UNSPECIFIED Cappucciati, Marco UNSPECIFIED UNSPECIFIED UNSPECIFIED Rutigliano, Grazia UNSPECIFIED orcid.org/0000-0001-6014-5357 UNSPECIFIED Schultze-Lutter, Frauke UNSPECIFIED UNSPECIFIED UNSPECIFIED Bonoldi, Ilaria UNSPECIFIED UNSPECIFIED UNSPECIFIED Borgwardt, Stefan UNSPECIFIED orcid.org/0000-0002-5792-3987 UNSPECIFIED Riecher-Roessler, Anita UNSPECIFIED UNSPECIFIED UNSPECIFIED Addington, Jean UNSPECIFIED UNSPECIFIED UNSPECIFIED Perkins, Diana UNSPECIFIED UNSPECIFIED UNSPECIFIED Woods, Scott W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mcglashan, Thomas H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lee, Jimmy UNSPECIFIED orcid.org/0000-0002-7724-7445 UNSPECIFIED Klosterkoetter, Joachim UNSPECIFIED UNSPECIFIED UNSPECIFIED Yung, Alison R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mcguire, Philip UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-392391
DOI:	10.1002/wps.20250
Journal or Publication Title:	World Psychiatry
Volume:	14
Number:	3
Page Range:	S. 322 - 333
Date:	2015
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	2051-5545
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ULTRA-HIGH-RISK; CLINICAL HIGH-RISK; PROSTATE-CANCER DETECTION; PRODROMAL CRITERIA; GENERAL-POPULATION; BASIC SYMPTOMS; YOUNG-ADULTS; PREVALENCE; SCHIZOPHRENIA; STATE Multiple languages Psychiatry Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/39239