Psychometric Properties of Prodromal Questionnaire-Brief Version among Chinese Help-Seeking Individuals

PLoS One. 2016 Feb 9;11(2):e0148935. doi: 10.1371/journal.pone.0148935. eCollection 2016.

Abstract

Prodromal Questionnaire (PQ) and Structured Interview for Prodromal Syndromes (SIPS) have been used as a two-stage process for identifying subjects at clinical high risk (CHR) of psychosis. The Prodromal Questionnaire-Brief version (PQ-B) contains 21 items derived from the PQ. The present study aimed to examine the psychometric properties of PQ-B in a Chinese help-seeking outpatient sample and to explore which items can better predict CHR diagnosis by SIPS and future transition to psychosis. In our preliminary epidemiological study, 1461 patients from a pool of 2101 individuals (15-45 years of age) completed the two-stage process. In the present study, 239 (20%) people were randomly selected among the sample who met the initial PQ-B screening criteria but had no positive diagnosis on SIPS, as well as 72 individuals with negative results on both PQ-B and SIPS, 89 prodromal and 105 psychotic subjects, yielding a total of 505 participants. The internal consistency coefficient for the PQ-B was good, with a Cronbach's alpha of 0.897. The concordant validity of PQ-B with SIPS dichotomized diagnosis of prodrome/psychosis versus no psychosis was 0.54. To ensure 80% or a higher sensitivity and a certain specificity, 7 and 24 were respectively set as the cutoff points for the PQ-B total score and distress score for Chinese help-seeking outpatients. A logistic regression model based on six PQ-B items could allow predicting the psychotic diagnosis on SIPS, with an accuracy of 65.8%. Prodromal individuals who scored higher on the 12th item of PQ-B (Do you worry at times that something may be wrong with your mind?) were less likely to convert to psychosis. PQ-B is a useful instrument for screening CHR subjects, but the cutoff score may be higher than that recommended by the author scores for help-seeking individuals in outpatient clinics. Some specific PQ-B items may have significant predictive power on dichotomized SIPS diagnoses and deserve special attention from researchers in future studies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • China
  • Female
  • Help-Seeking Behavior*
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / psychology*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Prodromal Symptoms*
  • Psychometrics
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / psychology*
  • Reproducibility of Results
  • Surveys and Questionnaires
  • Young Adult

Grants and funding

1. National Natural Science Foundation of China (81201043, 81171267, 81171280, 81372122, 81261120410,81361120403) (www.nsfc.gov.cn) (the study design, data collection and analysis) 2. Shanghai Science and Technology Committee (14411961400, 15411967200) (www.stcsm.gov.cn) (the study design, data collection and analysis) 3. National Key Clinical Disciplines at Shanghai Mental Health Center (Office of Medical Affairs, Ministry of Health, 2011-873; OMAMH, 2011-873) (www.smhc.org.cn) (data collection and analysis) 4. Shanghai Key Laboratory of Psychotic Disorders (13dz2260500) (www.smhc.org.cn) (data collection and analysis) 5. Shanghai health system advanced appropriate technology (2013SY003) (www.wsjsw.gov.cn/wsj/) (data collection and analysis) 6. Shanghai Municipal Natural Science Foundation (12ZR1448400) (www.stcsm.gov.cn) (preparation of the manuscript) 7. Shanghai Jiao Tong University Foundation (14JCRY04, YG2014MS40) (www.sjtu.edu.cn) (revised the manuscript)