Improving detection of first-episode psychosis by mental health-care services using a self-report questionnaire.
OBJECTIVE
To examine the utility of the Community Assessment of Psychic Experiences (CAPE)-42, a self-report questionnaire, to improve detection of first-episode psychosis in new referrals to mental health services.


METHODS
At first contact with mental health-care services patients were asked to complete the CAPE-42 and were then routinely diagnosed by a clinician. Standard diagnoses were obtained by means of the mini-Schedule for Clinical Assessment in Neuropsychiatry.


RESULTS
Of the 246 included patients, 26 (10.6%) were diagnosed with psychosis according to the mini-Schedule for Clinical Assessment in Neuropsychiatry. Only 10 of them were recognized by clinical routine, and 16 psychotic patients were not properly identified. Using an optimal cut-off of 50 on the frequency or distress dimension of the positive subscale of the CAPE-42 detected 14 of these misdiagnosed patients. The sensitivity of the CAPE-42 at this cut-off point was 77.5 and the specificity 70.5.


CONCLUSIONS
Systematic screening of patients using a self-report questionnaire for psychotic symptoms improves routine detection of psychotic patients when they first come into contact with mental health services.
Friesland Mental Health Services, Department of Education and Research, Leeuwarden, The Netherlands. nynke.boonstra@ggzfriesland.nl
Nynke
N
Boonstra
Lex
L
Wunderink
Sjoerd
S
Sytema
Durk
D
Wiersma
D000328:Adult; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis*; D012372:ROC Curve; D057566:Self Report; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires