The Early Psychosis Screener for Internet (EPSI)-SR: Predicting 12 month psychotic conversion using machine learning

SCHIZOPHRENIA RESEARCH

卷:208

Article

Brodey, B. B.¹  Girgis, R. R.²  Favorov, O. V.³  Bearden, C. E.^4,5  Woods, S. W.⁶  Addington, J.⁷  Perkins, D. O.⁸  Walker, E. F.^9,10  Cornblatt, B. A.¹¹  Brucato, G.²  Purcell, S. E.¹  Brodey, I. S.¹²  Cadenhead, K. S.¹³ 

[1] TeleSage Inc, 201 East Rosemary St, Chapel Hill, NC 27514 USA

[2] New York State Psychiat Inst & Hosp, 1051 Riverside Dr, New York, NY 10032 USA

[3] Univ N Carolina, Dept Biomed Engn, 152 MacNider Hall,Campus Box 7575, Chapel Hill, NC 27599 USA

[4] Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, 757 Westwood Plaza, Los Angeles, CA 90095 USA

[5] Univ Calif Los Angeles, Dept Psychol, 757 Westwood Plaza, Los Angeles, CA 90095 USA

[6] Connecticut Mental Hlth Ctr, PRIME Psychosis Prodrome Res Clin, B-38,34 Pk St, New Haven, CT 06519 USA

[7] Univ Calgary, Dept Psychiat, Hotchkiss Brain Inst, 3280 Hosp Dr NW, Calgary, AB T2N 4Z6, Canada

[8] Univ N Carolina, Sch Med, Dept Psychiat, 101 Manning Dr, Chapel Hill, NC 27514 USA

[9] Emory Univ, Dept Psychol, 36 Eagle Row, Atlanta, GA 30322 USA

[10] Emory Univ, Dept Psychiat, 36 Eagle Row, Atlanta, GA 30322 USA

[11] Zucker Hillside Hosp, Dept Psychiat Res, 75-59 263rd St, Glen Oaks, NY 11004 USA

[12] Univ N Carolina, Dept English & Comparat Literature, Chapel Hill, NC 27514 USA

[13] Univ Calif San Diego, Dept Psychiat, 9500 Gilman Dr, La Jolla, CA 92093 USA

关键词: SIPS;    PQ-B;    Schizophrenia;    First episode psychosis;    Attenuated psychotic syndrome;    Prodromal psychosis;   

DOI  :  10.1016/j.schres.2019.01.015

来源: Elsevier

【 摘 要 】

Introduction: A faster and more accurate self-report screener for early psychosis is needed to promote early identification and intervention. Methods: Self-report Likert-scale survey items were administered to individuals being screened with the Structured Interview for Psychosis-risk Syndromes (SIPS) and followed at eight early psychosis clinics. An a priori analytic plan included Spectral Clustering Analysis to reduce the item pool, followed by development of Support Vector Machine (SVM) dassifiers. Results: The cross-validated positive predictive value (PPV) of the EPSI at the default cut-off (76.5%) exceeded that of the clinician-administered SIPS (68.5%) at separating individuals who would not convert to psychosis within 12 months from those who either would convert within 12 months or who had already experienced a first episode psychosis (FEP). When used in tandem with the SIPS on clinical high risk participants, the EPSI increased the combined PPV to 86.6%. The SVM classified as FEP/converters only 1% of individuals in non-clinical and 4% of clinical low risk populations. Sensitivity of the EPSI, however, was 51% at the default cut-off. Discussion: The EPSI identifies, comparably to the SIPS but in less time and with fewer resources, individuals who are either at very high risk to develop a psychotic disorder within 12 months or who are already psychotic. At its default cut-off. EPSI misses 49% of current or future psychotic cases. The cut-off can, however, be adjusted based on purpose. The EPSI is the first validated assessment to predict 12-month psychotic conversion. An online screening system, www.eps.telesage.org, is under development (C) 2019 The Authors. Published by Elsevier B.V.

【 授权许可】

Free