Individuals who report psychotic-like experiences are at increased risk of future clinical psychotic disorder. They constitute a unique "high-risk" group for studying the developmental trajectory to schizophrenia and related illnesses. Previous research has used screening instruments to identify this high-risk group, but the validity of these instruments has not yet been established. We administered a screening questionnaire with 7 items designed to assess psychotic-like experiences to 334 adolescents aged 11-13 years. Detailed clinical interviews were subsequently carried out with a sample of these adolescents. We calculated sensitivity and specificity and positive predictive value (PPV) and negative predictive value (NPV) for each screening question for the specific symptom it enquired about and also in relation to any psychotic-like experience. The predictive power varied substantially between items, with the question on auditory hallucinations ("Have you ever heard voices or sounds that no one else can hear?") providing the best predictive power. For interview-verified auditory hallucinations specifically, this question had a PPV of 71.4% and an NPV of 90.4%. When assessed for its predictive power for any psychotic-like experience (including, but not limited to, auditory hallucinations), it provided a PPV of 100% and an NPV of 88.4%. Two further questions-relating to visual hallucinations and paranoid thoughts-also demonstrated good predictive power for psychotic-like experiences. Our results suggest that it may be possible to screen the general adolescent population for psychotic-like experiences with a high degree of accuracy using a short self-report questionnaire.
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"Psychotic experiences at ages 15 and 18. Psychotic experiences were targeted with the Adolescent Psychotic-like Symptom Screener [APSS; Kelleher et al., 2011]. Because the clinical and pathological significance of psychotic experiences other than auditory hallucinations (i.e., visual hallucinations and delusions of persecution , reference, control, special powers, and thought broadcasting ) is uncertain [Horwood et al., 2008; Kelleher et al., 2011], our main analyses concerned the item targeting auditory hallucinations during the last month: " Have you ever heard voices other people cannot hear. " Responses were coded 1 for " very often/often/ sometimes " and 0 for " never " . "
[Show abstract][Hide abstract] ABSTRACT: Studies suggest associations between childhood autistic traits and adolescent psychotic experiences. However, recent research suggests that a general neuropsychiatric problems factor predicts adverse outcomes better than specific diagnostic entities. To examine if the alleged association between autistic traits and psychotic experiences could rather be explained by a general neuropsychiatric problems factor comprising symptoms of ADHD, tic disorder, developmental coordination disorder, and learning disorder, we conducted a prospective cohort study based on the Child and Adolescent Twin Study in Sweden. In addition, we examined the genetic and environmental influences on the associations. A total of 9,282 twins with data on childhood autistic traits and other neuropsychiatric problems, and follow-up data on psychotic experiences at ages 15 and/or 18 years were included. First, psychotic experiences were regressed on autistic traits and second, the general neuropsychiatric problems factor was added to the model. Auditory hallucinations were analyzed separately from the other psychotic experiences. Finally, twin analyses were employed to disentangle genetic from environmental influences in the observed associations. Replicating prior research, significant associations were found between autistic traits in childhood and auditory hallucinations at ages 15 and 18. However, after controlling for the general neuropsychiatric problems factor, the associations between autistic traits and auditory hallucinations disappeared, whereas the association between the general neuropsychiatric problems factor and auditory hallucinations persisted after controlling for autistic traits. Twin analyses revealed that the association between the general neuropsychiatric problems factor and auditory hallucinations was driven by shared genetic influences.
American Journal of Medical Genetics Part B Neuropsychiatric Genetics 10/2015; 9999:1-7. DOI:10.1002/ajmg.b.32386 · 3.42 Impact Factor
"Krebs, Paris), ou le Structured Interview for Prodromal Symptoms (SIPS). Un outil simple d'emploi a également démontré son excellente valeur prédictive en population générale : le 7-items Adolescent Psychotic-like Symptom Screener (APSS) (Tableau 1)  . Une étude EMC -Psychatrie/Pédopsychiatrie menée chez 7900 enfants âgés de 9 à 11 ans a effectivement pu montrer que l'item 4 de l'APSS portant sur les expériences hallucinatoires auditives et l'item 6 portant sur les expériences hallucinatoires visuelles possédaient le plus grand pouvoir discriminant dans la détection d'un construct « psychose » dans cette tranche d'âge  . "
[Show abstract][Hide abstract] ABSTRACT: Les psychoses sont sans doute la préoccupation constante des psychiatres d'adolescents qui craignent avant tout l'entrée dans la schizophrénie qu'ils sont conduits à évoquer devant des symptômes très divers venant exprimer de façon polymorphe la souffrance psychique fréquente à cet âge. En effet, l'adolescence, qui est un moment de profondes mutations internes et externes, est aussi l'âge où s'installent la plupart des maladies psychiatriques de l'âge adulte, celles-ci n'ayant pas, à leur début, les caractéristiques cliniques qui les rendront plus tard plus facilement reconnaissables. Devant des symptômes psychotiques à l'adolescence, le clinicien doit donc envisager un large éventail de diagnostics différentiels sans pouvoir se fier aux descriptions nosographiques. Il est donc, plus qu'à d'autres âges de la vie, amené à prendre en compte la dimension psychopathologique des troubles autour de deux grands axes théoriques : l'Œdipe et le corps génital d'une part et la psychopathologie des liens d'autre part. S'interroger sur les psychoses à l'adolescence aujourd'hui c'est aussi tout à la fois tolérer un certain degré d'incertitude pronostique et se poser la question de la valeur des manifestations prémorbides apparaissant à cette période de la vie : facteurs de vulnérabilité ou prodromes de la maladie avec pour conséquence des modalités de traitement et de prévention qui peuvent être très différentes.
"However, briefly, a total of 1131 pupils from 16 schools in the 5th and the 6th class (that is, the two most senior years in the Irish national/primary school system), aged 11 to 13 years, participated in a survey of psychiatric symptoms, using the Strengths and Difficulties Questionnaire (SDQ) (Goodman et al., 2000), which is a validated self-report instrument that assesses emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems , and prosocial behaviour. This sample was also assessed for psychotic experiences, using the Adolescent Psychotic Symptom Screener (APSS), which is a validated self-report instrument that assesses hallucinations and delusions (Kelleher et al., 2011). These instruments were completed in school, with a member of the research team present in the classroom. "