Detecting incipient schizophrenia: a validation of the Azima battery in first episode psychosis.
Early psychosis intervention aims to accurately detect adolescents and young adults at risk for major mental disorders, particularly schizophrenia, yet early biomedical diagnostic accuracy remains poor. However, phenomenological approaches focusing on eliciting and understanding the subjective experience of help-seeking youth better detect incipient schizophrenia. The Azima Battery is an occupational therapy projective assessment that uses expressive media in a standard setup, in order to phenomenologically elicit and describe the activity performance and narratives of individuals at risk of, or on, the psychotic-spectrum.The purpose of this study was to estimate the predictive validity of the Azima Battery with youth seeking help for a first episode of psychosis, and identify patterns of performance distinctive of a diagnosis of schizophrenia 1-year later. A mixed methods phenomenological approach was used to calculate the predictive validity of the Azima Battery in detecting incipient schizophrenia, and to qualitatively identify patterns of performance. Study results demonstrate that the diagnostic accuracy of the Azima Battery is greater than psychiatric interviewing for a future diagnosis of schizophrenia (N = 62: 88.7 % vs 42 %). Performance elements and patterns statistically distinctive of schizophrenia are described, and relate to the structure of the created objects. Therefore, the Azima Battery is a valid measure for clinical use by occupational therapists working in early intervention for psychosis as a complement to traditional psychiatric interviewing.
School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec, H3G 1Y5, Canada. hiba.zafran@mcgill.ca.|Institute of Community and Family Psychiatry, Jewish General Hospital, 4333 Côte St-Catherine Road, Montreal, Quebec, H3T 1E4, Canada. hiba.zafran@mcgill.ca.
Hiba
0000-0002-6550-7879
H
Zafran
Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Jewish Rehabilitation Hospital, 3205 Place Alton Goldbloom, Laval, Quebec, H7V 1R2, Canada.|School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec, H3G 1Y5, Canada.
Barbara
B
Mazer
School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec, H3G 1Y5, Canada.
Beverlea
B
Tallant
School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec, H3G 1Y5, Canada.|Feil & Oberfeld/ CRIR Research Centre, Centre intégré de santé et de services sociaux de Laval, Hôpital juif de réadaptation, 3205, Place Alton-Goldbloom, Laval, Québec, H7V 1R2, Canada.
Gevorg
G
Chilingaryan
School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, Quebec, H3G 1Y5, Canada.|Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Jewish Rehabilitation Hospital, 3205 Place Alton Goldbloom, Laval, Quebec, H7V 1R2, Canada.
Isabelle
I
Gelinas
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007406:Interview, Psychological / Q000592:standards*; D008297:Male; D009788:Occupational Therapy; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011618:Psychotic Disorders / Q000175:diagnosis*; D012559:Schizophrenia / Q000000981:diagnostic imaging*; D055815:Young Adult
Activity performance; First episode psychosis; Occupational therapy projective assessment; Phenomenological mixed methods research; Predictive validity