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

被引:11
作者
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 ]
机构
[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; PRODROMAL QUESTIONNAIRE; INTERRATER RELIABILITY; RISK CALCULATOR; VALIDATION; VALIDITY; SYMPTOMS; PQ; INTERVIEW;
D O I
10.1016/j.schres.2019.01.015
中图分类号
R749 [精神病学];
学科分类号
100205 ;
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.
引用
收藏
页码:390 / 396
页数:7
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