Using the K-SADS psychosis screen to identify people with early psychosis or psychosis risk syndromes

Clin Child Psychol Psychiatry. 2019 Oct;24(4):809-820. doi: 10.1177/1359104519846582. Epub 2019 May 16.

Abstract

Background: Current methods to identify people with psychosis risk involve administration of specialized tools such as the Structured Interview for Psychosis-Risk Syndromes (SIPS), but these methods have not been widely adopted. Validation of a more multipurpose assessment tool-such as the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS)-may increase the scope of identification efforts.

Methods: We assessed the correspondence between SIPS-determined clinical high risk/early psychosis (CHR/early psychosis) status and K-SADS psychosis screen (child and parent reports and their combination) in a sample of 147 help-seeking individuals aged 12-25. Detailed classification results are reported.

Results: Both the child and parent interviews on the K-SADS psychosis screen were strongly predictive of CHR/early psychosis status, although parent reports contributed no significant additional information beyond child reports. Across informants, the presence of either subthreshold hallucinations or subthreshold delusions was highly suggestive of CHR/early psychosis status as determined by SIPS interview (78% (child) and 74% (parent) accuracy).

Conclusions: Subthreshold scores on the two-item K-SADS psychosis screen may be good indicators of the presence or absence of early signs of psychosis. The option of using a non-specialized assessment such as the K-SADS as a staged approach to assess for CHR/early psychosis status could increase rates of early psychosis screening and treatment.

Keywords: Clinical high-risk; early psychosis; psychosis; schizophrenia; ultrahigh risk.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Delusions / diagnosis*
  • Female
  • Hallucinations / diagnosis*
  • Humans
  • Male
  • Parents
  • Prognosis
  • Psychiatric Status Rating Scales* / standards
  • Psychotic Disorders / diagnosis*
  • Risk
  • Self Report
  • Young Adult