The CAARMS: Assessing Young People at Ultra High Risk of Psychosis. This manual is aimed at mental health professionals working with young people who. Mapping the Onset of Psychosis: The Comprehensive Assessment of At-Risk Mental . To assess predictive validity, the CAARMS-defined UHR criteria were. Comprehensive Assessment of At-Risk Mental States (CAARMS; the CAARMS before assessing psychosis risk, either through their headspace centre or.

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Such a substantial agreement is not completely surprising.

Mapping the onset of psychosis: the Comprehensive Assessment of At-Risk Mental States.

We additionally estimated the prevalence and bias adjusted kappa PABAK [ 21 ] which adjusts the kappa for imbalances caused by differences in prevalence and bias [ 22 ]. Our third aim was to develop an automated algorithm to convert individual cases and to validate it in an external sample.

Also, the functional decline criterion i. However, their operationalization differs [ 10 ], with substantial changes over different versions of the instruments [ 10 ]. Third, our procedure involving a unique rater scoring both instruments in an uncontrolled order may have significantly inflated agreement across instruments.

Referrals for both services are accepted from multiple sources including general practitioners, other mental health services, school and college counselors, relatives, and self-referrals [ 18 ]. Introduction The development of psychometric tools to prospectively identify subjects at ultra high clinical risk UHR hereafter of psychosis has allowed preventative screening [ 1 ], diagnosis [ 2 ], and interventions [ 3 ] to be feasible in psychiatry.

The development of psychometric psycjosis to prospectively identify subjects at ultra high clinical risk UHR hereafter of psychosis has allowed preventative screening [ 1 ], diagnosis [ 2 ], and interventions [ 3 ] to be feasible in psychiatry. This study had limitations.

However, type of recruitment strategies may have inflated the observed agreement and future studies should repeat these analyses in high-risk services adopting different outreach campaigns. Given evidence that baseline functional status is a strong predictor of longitudinal outcome [ 20 ], we further performed a weighted kappa analysis, weighting the three groups according to their relative baseline functional level, as established in our previous meta-analysis i.


Furthermore, we only included subjects who were directly assessed with both psychometric instruments during face-to-face interviews, excluding those who declined the full assessment or who were unable to complete it.

The pragmatic algorithm to convert individual cases across the SIPS 5.

Operationalization differences include disparity in psychopathological definitions of the APS, time and frequency criteria, functional decline criterion, BLIPS criteria, assessment of caxrms, and substance misuse see Tables 1 and 2 and eTable 1 in Supplementary Material available online at http: To receive news and publication updates for Psychiatry Journal, enter your email address in the box below.

The IRRs for each subscale were in the excellent range: Post hoc analyses see eTable 3 confirmed an overall substantial agreement across the two instruments with the exception of the cell [2,5: Each rater interviewed on average The primary aim of the study was investigated by comparing the diagnostic outcomes i.

Similarly, differences on psychosis threshold in the Perceptual Abnormalities subscale i.

Mapping the onset of psychosis: the Comprehensive Assessment of At-Risk Mental States.

The mean age ppsychosis of Our results are thus highly relevant to permit overall meaningful comparisons of clinical, neurobiological, neurocognitive, and cost-effectiveness UHR studies worldwide, with potential beneficial impact for ongoing large-scale multicentre UHR projects such as the PRONIA http: To freely download the tool and the template.

Psychometric diagnostic uncertainty questions validity of the UHR diagnostic interview, creating inconsistencies between clinicians or researchers and misunderstandings in patients [ 13 ].

View at Google Scholar P. To control for this we performed an independent analysis in a subset of patients assessed with independent raters and we confirmed that magnitude of agreement remained substantial see results in eMethod 1.

The ROC area serves as a global measure of test performance and values in the range of 0. Woods, The Psychosis-Risk Syndrome: This is an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided pstchosis original work is properly cited.


When the analysis was weighted for the relative functional impairment of the three groups the results were very similar: The results of the current investigation pychosis be highly relevant to the field, as they may inform future multicentre studies as well as international consensus conferences aiming at standardizing the UHR pschosis interview. InJackson and McGorry were the first to initiate reliability studies to psychometrically assess first-episode subjects via a semistructured interview in order to ascertain the presence of prodromal symptoms [ 4 ].

It is possible to speculate that the additional SIPS 5. This algorithm has been implemented in the CONVERT tool, which has been made freely available for the use of future researchers and clinicians and externally validated in an independent sample. Their pivotal work resulted in the formulation of three UHR criteria: A software engineer JL then implemented the conversion algorithm in an automated package. However, assessing subjects referred for suspicion of UHR symptoms at the time of the first contacts with high-risk services who may be already acarms or eventually deemed not at risk of psychosis with independent raters poses severe logistic difficulties for the patients.

First, the two instruments show similar psychometric parameters, such as excellent reliability properties overall IRR agreement for the SIPS 0. On one side the psychosis threshold is higher in the SIPS 5. Percent overall agreement, kappa, the McNemar-Bowker test, equipercentile methods, and residual analyses were used to investigate diagnostic outcomes and symptoms severity or frequency.

Indeed, the definition of case i. The kappa remained substantial when it was estimated in the subset of subjects rated by independent raters overall agreement CAMEO was started in and it is an early intervention in psychosis service which offers management for UHR people aged 17—35 in Cambridgeshire, UK, and provides initial assessments to those under