A new Algorithm for Detecting Clinical High Risk of Psychosis in Adolescents

• Mercedes Paíno ^[1] ; Ana María González-Menéndez ^[1] ; Óscar Vallina-Fernández ^[2] ; Mar Rus-Calafell ^[3]
  1. [1] Universidad de Oviedo

     Universidad de Oviedo

     Oviedo, España

     
  2. [2] Sierrallana Hospital, Cantabria Health Service, Torrelavega, Cantabria, Spain.
  3. [3] Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-University of Bochum, Bochum, Germany.

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• Localización: Psicothema, ISSN-e 1886-144X, ISSN 0214-9915, Vol. 34, Nº. 3, 2022, págs. 383-391
• Idioma: inglés
• DOI: 10.7334/psicothema2022.10
• Títulos paralelos:
  • Un Nuevo Algoritmo para la Detección del Alto Riesgo Clínico de Psicosis en Adolescentes
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• Resumen
  • español

    Antecedentes: La delimitación del alto riesgo clínico de psicosis (CHRp, por sus siglas en inglés) se caracteriza por la gran variedad de síntomas evaluados desde diferentes enfoques y la dificultad que existe para detectar los estadios clínicos más alejados del inicio de la psicosis. Este estudio tiene como objetivo la creación de un procedimiento sistemático para una detección temprana eficaz y precisa del CHRp en entornos educativos. Método: A partir de una muestra representativa de 1.824 adolescentes (edad, media= 15,79 años; 53,8%, mujeres) se ha desarrollado un sistema de evaluación online y un algoritmo de tres vías y tres niveles de riesgo que combina los síntomas de los principales enfoques de riesgo: ultra-alto riesgo (UHR), síntomas básicos (SB) y anomalías en la autoexperiencia subjetiva (ASE), además del déficit funcional. Resultados: A la luz de los datos obtenidos se han confirmado la aceptabilidad y viabilidad del sistema de cribado online. Del total de participantes, 68 (3,7%) fueron identificados como de alto riesgo y 417 (22,9%) como de riesgo moderado, lo que también avala la funcionalidad del algoritmo propuesto. Conclusiones: El sistema apoya la existencia de un modelo dinámico de progresión de los diferentes síntomas en las primeras etapas de la psicosis, y puede constituir una primera línea de identificación de los trastornos mentales graves en los jóvenes en las etapas más tempranas, de cara a la aplicación de las medidas preventivas iniciales.

  • English

    Background: The delimitation of the clinical high risk of psychosis (CHRp) is characterized by the wide variety of symptoms assessed from different approaches from the onset of psychosis. This study aimed to create a systematic procedure for an effective and accurate earlydetection of CHRp in educational settings. Method: A representative sample of 1,824 adolescents (average age, 15.79; 53.8%, women) was used to develop an online assessment system and a new 3-track, 3-level algorithm that combines symptoms of the main risk approaches: ultra-high risk (UHR), basic symptoms (BS), and anomalies in the subjective self-experience (ASE) with functional deficit. Results: The acceptability and feasibility of the online screening system were confirmed by the data. Of the total participants, 68 (3.7%) were identified as high-risk and 417 (22.9%) were identified as moderate, which also supports the functionality of the proposed algorithm. Conclusions: The system indicates a dynamic model of progression of the different symptoms in the early stages of psychosis, and it may constitute a first line of identification for severe mental disorders in young people in the earliest stages, allowing application of initial preventive measures.

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