Examining the predictive value of anxiety, depression, and suicidal ideation screening in determining psychosis risk

Psychosis is a medical and psychological term referring to an array of symptoms including perceptual disturbances, delusional beliefs, and disorganized behavior. Timely identification of psychotic disorders helps individuals be connected to early intervention or first-episode psychosis treatment programs which improve clinical and functional outcomes. Anxiety and depression are common comorbidities and may be precursors to psychotic disorders. Although screening for mental health within the primary care setting has increased in recent years, questions remain about who and when to screen for psychosis. Within a larger project exploring the feasibility of screening for psychosis in primary care, this project examines the relationship between three mental health screeners: the Prodromal Questionnaire-16 (PQ-16; used to identify individuals with psychosis symptoms), the Generalized Anxiety Disorder-7 (GAD-7; screens for anxiety), and the Patient Health Questionnaire-9 (PHQ-9; screens for depression with one question measuring suicide ideation). The current study examined the relationship between these three screeners in a sample of adolescent and young adult patients (N = 180) from four primarily pediatric practices in Maine. Patients completed all three screeners and were triaged by trained behavioral health clinicians into five clinical groups, which were collapsed into two groups: no psychosis concern or psychosis concern. Results demonstrated that depressive symptoms and suicidal ideation most consistently predicted psychosis risk, considering both self-report and psychosis-risk triage. These findings suggest prioritizing psychosis risk screening if young patients screen positive for depression and/or suicidal ideation.