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[Prediction of psychosis by stepwise multilevel assessment--the Basel FePsy (Early Recognition of Psychosis)-Project]
Journal
Fortschritte der Neurologie - Psychiatrie
Volume
81
Number
5
Pages / Article-Number
265-75
Mesh terms
Adult; Data Interpretation, Statistical; Disease Progression; Early Diagnosis; Electroencephalography; Female; Follow-Up Studies; Humans; Kaplan-Meier Estimate; Magnetic Resonance Imaging; Male; Predictive Value of Tests; Psychiatric Status Rating Scales; Psychomotor Performance; Psychotic Disorders, therapy; Risk Assessment; Socioeconomic Factors
Abstract
We have conducted various studies in Basel with the aim of improving the methods for the early detection of psychosis (Früherkennung von Psychosen, FePsy).; From 1.3.2000 to 29.2.2004 234 individuals were screened using the Basel Screening Instrument for Psychosis (BSIP). 106 patients were identified as at risk for psychosis; out of these 53 remained in follow-up for up to 7 years (mean 5.4 years). The assessments were done with a specifically developed instrument for history taking, various scales for the psychopathology, assessments of neuropsychology and fine motor functioning, clinical and quantitative EEG, MRI of the brain, laboratory etc.; Based on the BSIP alone, a relatively reliable prediction was possible: 21 (39.6%) of the individuals identified as at risk developed psychosis within the follow-up time. Post-hoc prediction could be improved to 81% by weighting psychopathology and including neuropsychology. Including the other domains obviously allows further improvements of prediction.; The risk for psychosis should be assessed in a stepwise procedure. In a first step, a clinically oriented screening should be conducted. If an at-risk status is found, further assessments in various domains should be done in a specialised centre.
