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DOI10.1093/schbul/sbx055
Diagnostic and Prognostic Significance of DSM-5 Attenuated Psychosis Syndrome in Services for Individuals at Ultra High Risk for Psychosis
Fusar-Poli, Paolo1,2; De Micheli, Andrea1,2; Cappucciati, Marco1,2; Rutigliano, Grazia1,2; Davies, Cathy1; Ramella-Cravaro, Valentina1,2; Oliver, Dominic1; Bonoldi, Ilaria1,2; Rocchetti, Matteo1,2; Gavaghan, Lauren2; Patel, Rashmi2,3; McGuire, Philip2,3
通讯作者Fusar-Poli, Paolo
来源期刊SCHIZOPHRENIA BULLETIN
ISSN0586-7614
EISSN1745-1701
出版年2018
卷号44期号:2页码:264-275
英文摘要

Background: The diagnostic and prognostic significance of the DSM-5-defined Attenuated Psychosis Syndrome (DSM-5-APS) in individuals undergoing an ultra high risk (UHR) clinical assessment for suspicion of psychosis risk is unknown. Methods: Prospective cohort study including all consecutive help-seeking individuals undergoing both a DSM-5-APS and a Comprehensive Assessment of At Risk Mental States (CAARMS 12/2006) assessment for psychosis risk at the Outreach and Support in South London (OASIS) UHR service (March 2013-April 2014). The diagnostic significance of DSM-5-APS was assessed with percent overall agreement, prevalence bias adjusted kappa, Bowker’s test, Stuart-Maxwell test, residual analysis; the prognostic significance with Cox regression, Kaplan-Meier failure function, time-dependent area under the curve (AUC) and net benefits analysis. The impact of specific revisions of the DSM-5-APS was further tested. Result: In 203 help-seeking individuals undergoing UHR assessment, the agreement between the DSM-5-APS and the CAARMS 12/2006 was only moderate (kappa 0.59). Among 142 nonpsychotic cases, those meeting DSM-5-APS criteria had a 5-fold probability (HR = 5.379) of developing psychosis compared to those not meeting DSM-5-APS criteria, with a 21-month cumulative risk of psychosis of 28.17% vs 6.49%, respectively. The DSM-5-APS prognostic accuracy was acceptable (AUC 0.76 at 24 months) and similar to the CAARMS 12/ 2006. The DSM-5-APS designation may be clinically useful to guide the provision of indicated interventions within a 7%-35% (2-year) range of psychosis risk. The removal of the criterion E or C of the DSM-5-APS may improve its prognostic performance and transdiagnostic value. Conclusions: The DSM-5-APS designation may be clinically useful in individuals accessing clinical services for psychosis prevention.


英文关键词psychosis schizophrenia CAARMS SIPS Prodromal DSM-5
类型Article
语种英语
国家England
收录类别SCI-E ; SSCI
WOS记录号WOS:000427534200009
WOS关键词CLINICAL HIGH-RISK ; METAANALYSIS ; PREVALENCE ; PREDICTION ; SYMPTOMS ; STATE ; CLASSIFICATION ; DISORDERS ; VALIDITY ; PEOPLE
WOS类目Psychiatry
WOS研究方向Psychiatry
来源机构University of London
资源类型期刊论文
条目标识符http://119.78.100.177/qdio/handle/2XILL650/212873
作者单位1.Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychosis Studies, Early Psychosis Intervent & Clin Detect EPIC Lab, London, England;
2.South London & Maudsley NHS Fdn Trust, OASIS Serv, London, England;
3.Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychosis Studies, London, England
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GB/T 7714
Fusar-Poli, Paolo,De Micheli, Andrea,Cappucciati, Marco,et al. Diagnostic and Prognostic Significance of DSM-5 Attenuated Psychosis Syndrome in Services for Individuals at Ultra High Risk for Psychosis[J]. University of London,2018,44(2):264-275.
APA Fusar-Poli, Paolo.,De Micheli, Andrea.,Cappucciati, Marco.,Rutigliano, Grazia.,Davies, Cathy.,...&McGuire, Philip.(2018).Diagnostic and Prognostic Significance of DSM-5 Attenuated Psychosis Syndrome in Services for Individuals at Ultra High Risk for Psychosis.SCHIZOPHRENIA BULLETIN,44(2),264-275.
MLA Fusar-Poli, Paolo,et al."Diagnostic and Prognostic Significance of DSM-5 Attenuated Psychosis Syndrome in Services for Individuals at Ultra High Risk for Psychosis".SCHIZOPHRENIA BULLETIN 44.2(2018):264-275.
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