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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The study samples were designed to reflect at-risk populations as they are encountered in day-to-day practice: The primary aim of the study was investigated by comparing the diagnostic outcomes i.

Qualitative analyses of discrepancies across the two instruments were also conducted, to better elucidate the impact of each specific cell on the overall results.

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

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

The secondary aim of the study was investigated using post hoc explorative residual caaarms comparing different subgroups i. The automated conversion algorithm CONVERT to convert individual cases was validated in an independent sample and showed an excellent accuracy.

Differences remain between the characteristics of the basic population, the recruitment of patients, the follow-up, and the specific treatments provided [ 9 ]. To freely download the tool and the template.

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

There is also recent meta-analytical evidence indicating that samples referred to high-risk services are psychoss heterogeneous psuchosis that their actual composition may reflect the type of outreach campaigns adopted [ 3637 ].

The authors thank Professor Scott Woods for his external advice on the use of the SIPS and on his personal comments on the disorganized and dangerous symptoms. The kappa remained substantial when it was estimated in the subset of subjects rated by independent raters overall agreement Subscribe to Table of Contents Alerts.


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

caarmms 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 ]. Woods, The Psychosis-Risk Syndrome: To elucidate this difference we conducted a qualitative analysis of the medical records of these 14 subjects. View at Google Scholar P.

The equipercentile cxarms between severity and frequency scores of the two instruments is detailed in Table 4. 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 ]. This method is detailed in eMethod 2.

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Residual and qualitative analyses and equipercentile-linking tables provided additional psgchosis data. Also, operationalization differences in APS onset criteria did not impact the overall consistency of the diagnostic interview for APS across the two instruments.

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 ].

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.

External validation was performed in an independent sample assessed for suspicion of UHR symptoms at the Seoul Youth Clinic see eTable 5. Our third aim was to develop a pragmatic algorithm to convert individual cases across the two instruments, to implement it in an automated conversion package CONVERTand to validate it in an independent UHR sample. Percent psychhosis agreement, kappa, the McNemar-Bowker test, equipercentile methods, and residual analyses were used to investigate diagnostic outcomes and symptoms severity or frequency.


The prevalence and bias adjusted kappa was 0. 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. Caagms diagnostic uncertainty questions validity of the UHR diagnostic interview, creating inconsistencies between clinicians or researchers and misunderstandings in patients [ 13 ].

Each rater interviewed on average Their diagnostic comparability is unknown. First, cxarms did not perform a follow-up.

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

Avoiding the use of external and non-help-seeking control groups who do not reflect the clinical composition of people actually assessed in high risk is essential to properly compare the diagnostic abilities caarms the two instruments.

Finally, in a recent meta-analysis we specifically confirmed that, in help-seeking samples, the two instruments share similar excellent prognostic accuracy in psycbosis out psychosis risk, with no significant differences [ 26 ].

For the SIPS 5. Their pivotal work resulted in the formulation of three UHR criteria: 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: This is an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

We further converted the severity and frequency of symptoms by employing a linking method, using equate 2.