| Publikationstyp: | Beitrag in wissenschaftlicher Zeitschrift |
| Art der Begutachtung: | Peer review (Publikation) |
| Titel: | Checking the predictive accuracy of basic symptoms against ultra high-risk criteria and testing of a multivariable prediction model : evidence from a prospective three-year observational study of persons at clinical high-risk for psychosis |
| Autor/-in: | Hengartner, Michael Pascal Heekeren, Karsten Dvorsky, Diane N. Walitza, Susanne Rössler, Wulf Theodoridou, Anastasia |
| DOI: | 10.1016/j.eurpsy.2017.05.026 |
| Erschienen in: | European Psychiatry |
| Band(Heft): | 45 |
| Seite(n): | 27 |
| Seiten bis: | 35 |
| Erscheinungsdatum: | 2017 |
| Verlag / Hrsg. Institution: | Elsevier |
| ISSN: | 0924-9338 1778-3585 |
| Sprache: | Englisch |
| Fachgebiet (DDC): | 616.89: Psychische Störungen, klinische Psychologie und Psychiatrie |
| Zusammenfassung: | Background: The aim of this study was to critically examine the prognostic validity of various clinical high-risk (CHR) criteria alone and in combination with additional clinical characteristics. Methods: A total of 188 CHR positive persons from the region of Zurich, Switzerland (mean age 20.5 years; 60.2% male), meeting ultra high-risk (UHR) and/or basic symptoms (BS) criteria, were followed over three years. The test battery included the Structured Interview for Prodromal Syndromes (SIPS), verbal IQ and many other screening tools. Conversion to psychosis was defined according to ICD-10 criteria for schizophrenia (F20) or brief psychotic disorder (F23). Results: Altogether n = 24 persons developed manifest psychosis within three years and according to Kaplan-Meier survival analysis, the projected conversion rate was 17.5%. The predictive accuracy of UHR was statistically significant but poor (area under the curve [AUC] = 0.65, P < .05), whereas BS did not predict psychosis beyond mere chance (AUC = 0.52, P = .730). Sensitivity and specificity were 0.83 and 0.47 for UHR, and 0.96 and 0.09 for BS. UHR plus BS achieved an AUC = 0.66, with sensitivity and specificity of 0.75 and 0.56. In comparison, baseline antipsychotic medication yielded a predictive accuracy of AUC = 0.62 (sensitivity = 0.42; specificity = 0.82). A multivariable prediction model comprising continuous measures of positive symptoms and verbal IQ achieved a substantially improved prognostic accuracy (AUC = 0.85; sensitivity = 0.86; specificity = 0.85; positive predictive value = 0.54; negative predictive value = 0.97). Conclusions: We showed that BS have no predictive accuracy beyond chance, while UHR criteria poorly predict conversion to psychosis. Combining BS with UHR criteria did not improve the predictive accuracy of UHR alone. In contrast, dimensional measures of both positive symptoms and verbal IQ showed excellent prognostic validity. A critical re-thinking of binary at-risk criteria is necessary in order to improve the prognosis of psychotic disorders. |
| URI: | https://digitalcollection.zhaw.ch/handle/11475/2221 |
| Volltext Version: | Publizierte Version |
| Lizenz (gemäss Verlagsvertrag): | Lizenz gemäss Verlagsvertrag |
| Departement: | Angewandte Psychologie |
| Organisationseinheit: | Psychologisches Institut (PI) |
| Enthalten in den Sammlungen: | Publikationen Angewandte Psychologie |
Dateien zu dieser Ressource:
Es gibt keine Dateien zu dieser Ressource.
Zur Langanzeige
Hengartner, M. P., Heekeren, K., Dvorsky, D. N., Walitza, S., Rössler, W., & Theodoridou, A. (2017). Checking the predictive accuracy of basic symptoms against ultra high-risk criteria and testing of a multivariable prediction model : evidence from a prospective three-year observational study of persons at clinical high-risk for psychosis. European Psychiatry, 45, 27–35. https://doi.org/10.1016/j.eurpsy.2017.05.026
Hengartner, M.P. et al. (2017) ‘Checking the predictive accuracy of basic symptoms against ultra high-risk criteria and testing of a multivariable prediction model : evidence from a prospective three-year observational study of persons at clinical high-risk for psychosis’, European Psychiatry, 45, pp. 27–35. Available at: https://doi.org/10.1016/j.eurpsy.2017.05.026.
M. P. Hengartner, K. Heekeren, D. N. Dvorsky, S. Walitza, W. Rössler, and A. Theodoridou, “Checking the predictive accuracy of basic symptoms against ultra high-risk criteria and testing of a multivariable prediction model : evidence from a prospective three-year observational study of persons at clinical high-risk for psychosis,” European Psychiatry, vol. 45, pp. 27–35, 2017, doi: 10.1016/j.eurpsy.2017.05.026.
HENGARTNER, Michael Pascal, Karsten HEEKEREN, Diane N. DVORSKY, Susanne WALITZA, Wulf RÖSSLER und Anastasia THEODORIDOU, 2017. Checking the predictive accuracy of basic symptoms against ultra high-risk criteria and testing of a multivariable prediction model : evidence from a prospective three-year observational study of persons at clinical high-risk for psychosis. European Psychiatry. 2017. Bd. 45, S. 27–35. DOI 10.1016/j.eurpsy.2017.05.026
Hengartner, Michael Pascal, Karsten Heekeren, Diane N. Dvorsky, Susanne Walitza, Wulf Rössler, and Anastasia Theodoridou. 2017. “Checking the Predictive Accuracy of Basic Symptoms against Ultra High-Risk Criteria and Testing of a Multivariable Prediction Model : Evidence from a Prospective Three-Year Observational Study of Persons at Clinical High-Risk for Psychosis.” European Psychiatry 45: 27–35. https://doi.org/10.1016/j.eurpsy.2017.05.026.
Hengartner, Michael Pascal, et al. “Checking the Predictive Accuracy of Basic Symptoms against Ultra High-Risk Criteria and Testing of a Multivariable Prediction Model : Evidence from a Prospective Three-Year Observational Study of Persons at Clinical High-Risk for Psychosis.” European Psychiatry, vol. 45, 2017, pp. 27–35, https://doi.org/10.1016/j.eurpsy.2017.05.026.
Alle Ressourcen in diesem Repository sind urheberrechtlich geschützt, soweit nicht anderweitig angezeigt.