Prediction of Psychosis Onset Among Subjects with Suspected Pre-Psychotic State: Neuropsychological Tests Versus Shcizotypy Questionnaires
Date Issued
2012
Date
2012
Author(s)
Mao, Chen-Chi
Abstract
Aim: This study aimed to 1) assess whether the scores on neuropsychological performance or schizotypy questionnaires were associated with psychosis initiation among subjects with suspected pre-psychotic state; and 2) compare the predictive accuracy of transition to psychosis by different models incorporating neuropsychological tests, schizotypy questionnaires, or both.
Method: Fifty-nine subjects at ultra-high-risk (UHR) of psychosis were followed for a mean of 2 years. Subjects were interviewed using the Diagnostic Interview for Genetic Studies (DIGS) and Scale of Prodromal Symptoms (SOPS). Schizotypy was measured using the Perceptual Aberration Scale (PAS), Schizotypal Personality Questionnaire (SPQ), Chinese Health Questionnaire (CHQ) and Youth Self Report (YSR). Neuropsychological functioning was evaluated using Continuous Performance Test (CPT) and Wisconsin Card Sort Test (WCST). Outcome comparisons were conducted using either chi-square test or t test, and correlates of baseline measures were examined using cox regression. Model building used Cox regression and found the minimum of AIC. The discriminatory ability of prediction models was determined using ROC curve.
Results: At 2-years follow-up, 21 UHR subjects converted to full-blown psychosis. In neuropsychological functioning, WCST Categories Achieved and Nonperseverative Errors (both Ps < 0.05) were associated with psychosis conversion. In interview schedules and self-administered questionnaires, YSR Withdrawn (P < 0.05) and SPQ Excessive Social Anxiety, Interpersonal Deficits (both Ps < 0.05) and SOPS Positive Subscales score (P < 0.05) were associated with psychosis conversion. The predictors for neuropsychological model and questionnaire model, respectively, were selected by stepwise regression. The estimated AUC for the model combined neuropsychological variables and questionnaire variables had the best AUC.
Conclusion: Neuropsychological functioning and schizotypal personality questionnaires were practically association with conversion. The prediction model combining neuropsychological assessment and psychosocial assessment identified an increased risk of psychosis with appropriate prognostic accuracy in our sample. This prediction model could be future replicated in independent samples
Subjects
Prediction
pre-psychotic state
neuropsychological tests
schizotypy questionnaires
Type
thesis
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