[Screening for psychosis risk in adolescence]

The first signs of psychosis often emerge during adolescence, making this phase suitable for early detection. However, mild and transient psychotic symptoms are more common in adolescents than adults, reducing certainty of early detection.

To examine whether the standard early detection approach used in adults is feasible in adolescents aged 12-18 years.

At intake in youth mental health services, the Child Behavior Checklist (CBCL), Youth Self-Report (YSR), and the 16-item version of the Prodromal Questionnaire (PQ-16) were administered. Adolescents scoring ≥ 6 on the PQ-16 and a sample with lower scores were invited for a Comprehensive Assessment of At-Risk Mental States (CAARMS) to determine the optimal cutoff. One year after establishing ultra high risk (UHR) status, the CAARMS was repeated.

An optimal PQ-16 cutoff score of 7 was identified (sensitivity = 0.85, specificity = 0.42, positive predictive value = 51.3%). After one year, half of the subjects no longer met UHR criteria, one fifth remained UHR, one fifth dropped out and one tenth transitioned to psychosis.

Systematic screening in youth mental health care is feasible and enables identification of both risk for and the presence of psychosis, supporting timely intervention. More research on cost-effectiveness is needed.