Background: Early detection of psychosis is an important issue in current research. Early intervention helps to improve the outcome of the disorder. Therefore, a comprehensive examination in large populations, necessary as it might be, is economically almost not feasible. A screening via self-report is more practicable as it helps focus on individuals with high symptom loads. Results: Both groups (cases and non-cases) showed significant differences in their mean scores on SPro and ESI, although only the SPro had satisfactory effect sizes. In hierarchic logistic regression models the SPro turned out to be highly predictive for caseness while ESI scales were not significant. A cut-off score of ≥2 on the Spro subscale for psychotic risk (SPro-Psy-Risk) was found to identify caseness best with a sensitivity of 74% and a specificity of 61%.
Conclusion:The SPro has proven to be a valid and very economic screening tool for general and prodromal pathology in large populations.
In the treatment of adult attention-deficit/hyperactivity disorder (ADHD) the importance of psychological interventions in combination with pharmacotherapy is widely accepted in contemporary clinical routine. The natural course of the disorder seems to justify additional psychological interventions because even in patients who are highly compliant to pharmacotherapy full remission is not always achieved. The aim of the present study was to analyze the contribution of psychotherapy to the treatment of adult ADHD patients. In a randomized controlled study, the efficacy of a combined treatment of psychotherapy with pharmacotherapy is compared to pharmacological intervention alone. After initiation and stabilization of treatment with methylphenidate (MPH) in all subjects randomization to the two different treatment conditions was done. Afterwards both groups underwent treatment for about 10–12 weeks, the experimental group receiving sessions of cognitive-behavioral therapy (CBT) whereas the control group only received medication and standard clinical management (SCM). ADHD symptoms differed statistically during time but not between the two different treatment conditions. This result was the same for the single ADHD symptoms—inattention, hyperactivity, impulsivity, and emotional symptoms—and also for impairment. Individual standardized ADHD specific CBT program was not able to outperform SCM.
Symptoms of attention-deficit/hyperactivity disorder (ADHD) and psychosis risk share features which might represent an early vulnerability marker for schizophrenia. Early detection of individuals with this symptomatic overlap is relevant and may assist clinicians in their decision making for diagnosis and treatment. This study sought to analyze the capability of different instruments in the screening of patients for ADHD symptoms or at psychosis risk, assess their classification accuracy, and describe the extent of symptoms overlap between them. 243 adult patients completed one instrument screening for ADHD and two instruments screening for psychosis risk symptoms [Adult ADHD Self-Report Scale Symptom Checklist (ASRS-v1.1); Prodromal Questionnaire Brief Version (PQ-16); Self-Screen Prodrome (SPro)]. The ability of these instruments to distinguish between the symptomaticity of these patients appears modest. The most satisfactory scale to identify subjects at psychosis risk was SPro with its subscale psychosis risk. ASRS-v1.1 showed good reliability in assessing individuals as not having ADHD symptoms and had higher probability to achieve its own and the cut-off of another questionnaire. Subjects having symptoms of psychosis risk and ADHD showed elevated symptomatology. Reliable instruments capable of separating ADHD symptoms from those of psychosis risk are needed to better identify the symptomatic overlap of this two conditions.
Grundlage der Diagnostik der ADHS (Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung) im Erwachsenenalter ist in der Regel die DSM-IV- oder ICD-10-Klassifikation. Für die Psychopathologie der Erwachsenen sind diese Systeme nur bedingt geeignet. Die Utah-Kriterien, die mit dem Wender-Reimher-Interview (WRI) erfasst werden können, beziehen sich explizit auf das Erwachsenenalter. Ziel der vorliegenden Studie war, die psychometrischen Charakteristiken sowie die Verteilung und Kombination der sieben Bereiche des WRI zu untersuchen und zudem einen Vergleich mit anderen Selbst- und Fremdbeurteilungsverfahren der ADHS-Diagnostik zu ziehen. Die Skalenhomogenität des WRI lag mit einem Cronbachs α von .88 hoch. Die Interrater-Reliabilität lag auf Itemebene zwischen .45 und .95. Hohe Korrelationen mit anderen Instrumenten bestätigten die konvergente Validität des Interviews. Das WRI erwies sich als ein reliables und valides Instrument, das über das dreidimensionale Modell der ADHS Unaufmerksamkeit, Hyperaktivität und Impulsivität hinausgeht und dabei die Symptomatik der erwachsenen ADHS-Patienten besser berücksichtigt.
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