Self-reported psychotic experiences in the general population: a valid screening tool for DSM-III-R psychotic disorders?
OBJECTIVE
To examine the diagnostic value of self-reported psychotic-like experiences for DSM-III-R psychotic disorders.


METHODS
A general population sample of 7076 subjects aged 18-64 years was interviewed with the Composite International Diagnostic Interview (CIDI) and, if there was evidence of psychotic experiences, the Structured Clinical Interview for DSM-III-R.


RESULTS
The probability of having a psychotic disorder increased in a dose-response fashion with the level of self-reported psychotic experiences, but individual CIDI psychotic experience ratings had relatively low post-test probabilities (PPs) (range: 5.1-26.5%). However, limiting the sample to individuals who had been in contact with mental health services substantially improved PPs (range: 13.3-43.1%).


CONCLUSIONS
Screening for psychosis in the population carries a high risk of stigmatization in false-positive cases and violation of the right 'not to know' in true-positive cases. However, in mental health care users, self-reported psychotic experiences may be a useful screening tool in individuals who have already developed help-seeking.
Hanssen
M S S
MS
Department of Psychiatry and Neuropsychology, EURON, azM/Mondriaan/Riagg/Vijverdal Academic Centre, Maastricht University, Maastricht, The Netherlands.
Bijl
R V
RV
Vollebergh
W
W
van Os
J
J
D000328:Adult; D000368:Aged; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors