Predicting psychosis in a general adolescent psychiatric sample.

Area of Science:

• Psychiatry
• Adolescent Mental Health
• Psychosis Risk Assessment

Background:

• Psychosis risk criteria are typically studied in specialized clinics.
• The utility of the Structured Interview for Prodromal Syndromes (SIPS) in general adolescent psychiatric care is underexplored.

Purpose of the Study:

• To assess the effectiveness of SIPS for screening psychosis risk in adolescents receiving general psychiatric care.
• To evaluate the predictive validity of Clinical High-Risk (CHR) status in this population.

Main Methods:

• 161 adolescents (15-18 years) with first psychiatric admission were interviewed using SIPS.
• Participants were followed for 2.8-8.9 years using registers and interviews.
• Outcomes included hospital care for primary psychotic disorder and any psychiatric disorder.

Main Results:

• 33.5% met Clinical High-Risk (CHR) criteria. Psychosis conversion occurred in 3/54 CHR individuals.
• Positive predictive value for CHR was low (1.9%), but negative predictive value was high (98.0%).
• Baseline SIPS positive symptom intensity predicted hospital admissions for primary psychotic disorder; CHR status predicted overall psychiatric hospitalization in longer follow-up.

Conclusions:

• Psychosis incidence was low in this unselected adolescent psychiatric sample.
• CHR status did not significantly predict psychosis at 12 months but predicted psychiatric hospitalization in longer-term follow-up.
• SIPS may be a useful tool for identifying adolescents at risk for broader psychiatric hospitalization, not just psychosis.