Using the K-SADS psychosis screen to identify people with early psychosis or psychosis risk syndromes

Abstract

Background: Current methods to identify people with psychosis risk involve administration of specialized tools such as the Structured Interview for Psychosis-Risk Syndromes (SIPS), but these methods have not been widely adopted. Validation of a more multipurpose assessment tool—such as the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS)—may increase the scope of identification efforts. Methods: We assessed the correspondence between SIPS-determined clinical high risk/early psychosis (CHR/early psychosis) status and K-SADS psychosis screen (child and parent reports and their combination) in a sample of 147 help-seeking individuals aged 12–25. Detailed classification results are reported. Results: Both the child and parent interviews on the K-SADS psychosis screen were strongly predictive of CHR/early psychosis status, although parent reports contributed no significant additional information beyond child reports. Across informants, the presence of either subthreshold hallucinations or subthreshold delusions was highly suggestive of CHR/early psychosis status as determined by SIPS interview (78% (child) and 74% (parent) accuracy). Conclusions: Subthreshold scores on the two-item K-SADS psychosis screen may be good indicators of the presence or absence of early signs of psychosis. The option of using a non-specialized assessment such as the K-SADS as a staged approach to assess for CHR/early psychosis status could increase rates of early psychosis screening and treatment.

Risk of psychosis in autism spectrum disorder individuals exposed to psychosocial stressors: A 9‐year chart review study

“…Included referrals were either scheduled (e.g., upon referral from liaison neuropsychiatrists for diagnostic or therapeutic purposes) or urgent (e.g., after initial Emergency Department (ED) assessment or transfer from other inpatient wards/peripheral hospitals). The occurrence of positive psychotic symptoms (e.g., delusions, hallucinations) and/or manic symptoms (e.g., grandiosity, flight of ideas, and increased goal‐directed activities) at the time of admission had to be clearly established by a senior clinician, following the child‐administered Kiddie Schedule for Affective Disorders and Schizophrenia (K‐SADS)—Psychosis and Mania screening, based on the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM‐5) criteria (Tsuji et al, 2019). Information about personal medical history, family history, and psychosocial context was collected from each patient's parents or caregivers by two experienced interviewers (e.g., physician and a psychologist) independently of each other.…”

Association between family functioning and psychotic transition in ultra-high risk adolescents and young adults

“…This rate is high relative to most clinical samples (44), which can be explained in part by the emergency help-seeking context in which patients consult. The rate of psychotic transition seems to be higher with the severity of the initial motive for consultation (45)(46)(47)(48). Of these UHR patients, 62% had sought care for psychiatric symptoms before inclusion in the study, and 20% were already receiving psychopharmacological treatment.…”