Diagnostic and Prognostic Significance of DSM-5 Attenuated Psychosis Syndrome in Services for Individuals at Ultra High Risk for Psychosis

Schizophrenia Bulletin
P Fusar-PoliP McGuire

Abstract

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. 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. 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-mon...Continue Reading

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Citations

Jul 4, 2019·Journal of Managed Care & Specialty Pharmacy·Anna WallaceMichael Sand
Mar 15, 2019·European Psychiatry : the Journal of the Association of European Psychiatrists·Magdalena Kotlicka-AntczakPaolo Fusar-Poli
Nov 21, 2019·JAMA Psychiatry·Gonzalo Salazar de PabloPaolo Fusar-Poli
Jul 28, 2020·American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics : the Official Publication of the International Society of Psychiatric Genetics·Cynthia B SolotRaquel E Gur
Aug 5, 2017·Drugs·Selene R T VeermanLieuwe de Haan
Sep 27, 2019·Journal of Managed Care & Specialty Pharmacy·Anna WallaceMichael Sand
Nov 17, 2020·Frontiers in Psychiatry·Gonzalo Salazar de PabloChristoph U Correll
Dec 8, 2020·Frontiers in Psychiatry·Line WidingIngrid Melle

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