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Self-reported psychotic experiences in the general population: a valid screening tool for DSM-III-R psychotic
M S S Hanssen1, R V Bijl, W Vollebergh
1Department of Psychiatry and Neuropsychology, EURON, azM/Mondriaan/Riagg/Vijverdal Academic Centre, Maastricht University, Maastricht, The Netherlands.
Objective:
To examine the diagnostic value of self-reported psychotic-like experiences for DSM-III-R psychotic disorders.
Method:
A general population sample of 7076 subjects aged 18-64 years was interviewed with the Composite International Diagnostic Interview (CIDI) and, if there was evidence of psychotic experiences, the Structured Clinical Interview for DSM-III-R.
Results:
The probability of having a psychotic disorder increased in a dose-response fashion with the level of self-reported psychotic experiences, but individual CIDI psychotic experience ratings had relatively low post-test probabilities (PPs) (range: 5.1-26.5%). However, limiting the sample to individuals who had been in contact with mental health services substantially improved PPs (range: 13.3-43.1%).
Conclusion:
Screening for psychosis in the population carries a high risk of stigmatization in false-positive cases and violation of the right 'not to know' in true-positive cases. However, in mental health care users, self-reported psychotic experiences may be a useful screening tool in individuals who have already developed help-seeking.