Using online screening in the general population to detect participants at clinical high-risk for psychosis

Mhairi McDonald, Eleni Christoforidou, Nicola Van Rijsbergen, Ruchika Gajwani, Joachim Gross, Andrew Gumley, Stephen Lawrie, Matthias Schwannauer, Frauke Schultze-Lutter, Peter J. Uhlhaas

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Introduction: Identification of participants at clinical high-risk (CHR) for the development of psychosis is an important objective of current preventive efforts in mental health research. However, the utility of using web-based screening approaches to detect CHR participants at the population level has not been investigated. Methods: We tested a web-based screening approach to identify CHR individuals.Potential participants were invited to a website via e-mail invitations, flyers, and invitation letters involving both the general population and mental health services. Two thousand two hundred seventy-nine participants completed the 16-item version of the prodromal questionnaire (PQ-16)and a 9-item questionnaire of perceptual and cognitive aberrations (PCA) for the assessment of basic symptoms(BS) online. 52.3% of participants met a priori cut-off criteria for the PQ and 73.6% for PCA items online. One thousand seven hundred eighty-seven participants were invited for a clinical interview and n = 356 interviews were conducted (response rate: 19.9%) using the Comprehensive Assessment of At-Risk Mental State (CAARMS) and the Schizophrenia Proneness Interview, Adult Version (SPIA).n = 101 CHR participants and n = 8 first-episode psychosis(FEP) were detected. ROC curve analysis revealed good to moderate sensitivity and specificity for predicting CHR status based on online results for both UHR and BS criteria (sensitivity/specificity: PQ-16 = 82%/46%;PCA = 94%/12%). Selection of a subset of 10 items from both PQ-16 and PCA lead to an improved of specificity of 57% while only marginally affecting sensitivity (81%).CHR participants were characterized by similar levels of functioning and neurocognitive deficits as clinically identified CHR groups. Conclusion: These data provide evidence for the possibility to identify CHR participants through population-based web screening. This could be an important strategy for early intervention and diagnosis of psychotic disorders.
Original languageEnglish
Article numbersby069
JournalSchizophrenia Bulletin: The Journal of Psychoses and Related Disorders
Publication statusPublished - 8 Jun 2018
Event6th Biennial SIRS Conference - Firenze Fiera Spa, Florence, Italy
Duration: 4 Apr 20188 Apr 2018

Keywords / Materials (for Non-textual outputs)

  • clinical high-risk
  • psychosis
  • early intervention
  • web screening
  • basic symptoms


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