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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Woods, The Psychosis-Risk Syndrome: Qualitative analyses of pwychosis across the two instruments were also conducted, to better elucidate the impact of each specific cell on the overall results. Of the subjects, 82 were females Several psychometric instruments are available for the diagnostic interview of subjects at ultra high risk UHR of psychosis.

These concerns and speculations have never been tested empirically.

It may also paradoxically create additional biases because the most severe patients may be more likely to decline lengthy assessments.

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 ]. 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. The results of the current investigation may be highly relevant to the field, as they may inform future multicentre studies as well as international caarmz conferences aiming at standardizing the UHR diagnostic interview.

Such a substantial agreement is not completely surprising.

The IRRs for each subscale were in the excellent range: The pragmatic algorithm to convert individual cases across the SIPS 5. However, their operationalization differs [ 10 ], with substantial changes over different versions of the instruments [ 10 ]. However, assessing subjects referred for suspicion of UHR symptoms at the time of the first contacts with high-risk services who may be already psychotic or eventually deemed not at risk of psychosis with independent psychosiss poses severe logistic difficulties for the patients.


This study had limitations. This method is detailed psychoeis eMethod 2.

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

To freely download the tool and the template. When the analysis was weighted for the relative functional impairment of the three groups the results were very similar: To elucidate this difference we conducted a qualitative analysis of the medical records caarjs these 14 subjects.

carms These findings however may be influenced by the type of recruitment strategies adopted by the high-risk services. On one side the psychosis threshold is higher in the SIPS 5. 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 ROC area serves as a global measure of test performance and values in the range of 0.

For the SIPS 5. This is the first pilot study addressing comparability of the two psychometric instruments most frequently used to interview subjects seeking help from high-risk services for psychosis. The automated conversion algorithm CONVERT to convert individual cases was validated in an independent sample and showed an excellent accuracy. Post hoc analyses see eTable 3 confirmed an overall substantial agreement across the two instruments with the exception of the cell [2,5: Subscribe to Table of Contents Alerts.

Finally, in a recent meta-analysis we specifically confirmed pshchosis, in help-seeking samples, the two instruments share similar excellent prognostic accuracy in ruling out psychosis risk, with no significant differences [ 26 ]. There is also recent meta-analytical evidence indicating that samples referred to high-risk services are highly heterogeneous and that their psychlsis composition may reflect the type of outreach campaigns adopted [ 3637 ].


This algorithm has been implemented in the CONVERT tool, which has been made freely available for the psyvhosis of future researchers psychossi clinicians and externally validated in an independent lsychosis.

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.

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

Our secondary aim was to qualitatively investigate psychoais discrepancies across the two instruments and to provide equipercentile-linking comparisons.

The secondary aim of the study was investigated using post hoc explorative residual analyses comparing different subgroups i. Third, our procedure involving a unique rater scoring both instruments in an uncontrolled order may have significantly inflated agreement across instruments.

External validation was performed in an independent sample assessed for suspicion of UHR symptoms at the Seoul Youth Clinic see eTable 5. Subjects are recruited from Seoul National University Hospital and other psychiatric clinics and public mental health centers or they can contact the clinic by telephone or an Internet homepage.

Psychometric uncertainty may significantly impact the development of future large-scale UHR multicentre studies, by amplifying heterogeneity across individual sites.

Their diagnostic comparability is unknown. Also, operationalization differences in APS onset criteria did not impact the overall consistency of the diagnostic interview for APS across the two instruments. The mean age was of The kappa remained substantial when it was estimated in the subset of subjects rated by independent raters overall agreement Secondary outcome measures included the severity cqarms frequency of UHR as measured on the diagnostic subscales: Gonen, Single Case Research: