Screening for psychotic experiences and psychotic disorders in general psychiatric settings: a systematic review and meta-analysis.

Autor:	Clauss JA; Psychosis Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA., Foo CYS; Psychosis Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.; Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA., Leonard CJ; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA., Dokholyan KN; Psychosis Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA., Cather C; Psychosis Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.; Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA., Holt DJ; Psychosis Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
Jazyk:	angličtina
Zdroj:	MedRxiv : the preprint server for health sciences [medRxiv] 2024 Apr 15. Date of Electronic Publication: 2024 Apr 15.
DOI:	10.1101/2024.04.14.24305796
Abstrakt:	Background: The absence of systematic screening for psychosis within general psychiatric services contribute to substantial treatment delays and poor long-term outcomes. We conducted a meta-analysis to estimate rates of psychotic experiences, clinical high-risk for psychosis syndrome (CHR-P), and psychotic disorders identified by screening treatment-seeking individuals to inform implementation recommendations for routine psychosis screening in general psychiatric settings. Methods: PubMed and Web of Science databases were searched to identify empirical studies that contained information on the point prevalence of psychotic experiences, CHR-P, or psychotic disorders identified by screening inpatient and outpatient samples aged 12-64 receiving general psychiatric care. Psychotic experiences were identified by meeting threshold scores on validated self-reported questionnaires, and psychotic disorders and CHR-P by gold-standard structured interview assessments. A meta-analysis of each outcome was conducted using the Restricted Maximum Likelihood Estimator method of estimating effect sizes in a random effects model. Results: 41 independent samples (k=36 outpatient) involving n=25,751 patients (58% female, mean age: 24.1 years) were included. Among a general psychiatric population, prevalence of psychotic experiences was 44.3% (95% CI: 35.8-52.8%; 28 samples, n=21,957); CHR-P was 26.4% (95% CI: 20.0-32.7%; 28 samples, n=14,395); and psychotic disorders was 6.6% (95% CI: 3.3-9.8%; 32 samples, n=20,371). Conclusions: High rates of psychotic spectrum illness in general psychiatric settings underscore need for secondary prevention with psychosis screening. These base rates can be used to plan training and resources required to conduct assessments for early detection, as well as build capacity in interventions for CHR-P and early psychosis in non-specialty mental health settings. Competing Interests: Conflicts of Interest and Sources of Funding: The authors report no conflicts of interest. Dr. Clauss was supported by the Dupont Warren Fellowship of Harvard Psychiatry, Louis V. Gerstner Scholar Award, and the Chen Institute Mass General Neuroscience Transformative Scholar Award. Dr. Foo was supported by funding from the Massachusetts Department of Mental Health to the Massachusetts General Hospital Center of Excellence for Psychosocial and Systemic Research, Sidney R. Baer, Jr Foundation, and the National Institute of Mental Health (P50 MH115846–05). Catherine Leonard was supported by funding from the Massachusetts Department of Mental Health to the Massachusetts General Hospital Center of Excellence for Psychosocial and Systemic Research. Dr. Cather was supported by funding from the Massachusetts Department of Mental Health to the Massachusetts General Hospital Center of Excellence for Psychosocial and Systemic Research. Dr. Holt was supported by funding from the National Institute of Mental Health (R01MG127265; R01MH125426; and R01MH122371-SCH), the Massachusetts Department of Mental Health, and the Sidney R. Baer, Jr Foundation.
Databáze:	MEDLINE
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