Validation of a modified version of the PRIME screen for psychosis-risk symptoms in a non-clinical Kenyan youth sample

Abstract

Background The PRIME screen is a self-administered questionnaire designed to quickly assess individuals at risk for developing a psychotic disorder. It is shorter in both length and administration time compared to the Structured Interview for Psychosis-Risk Syndromes (SIPS)—a standard instrument for psychosis prodromal risk assessment. Validation of the PRIME against the SIPS has not been reported in large non-clinical populations. Methods A culturally modified version of the PRIME screen (mPRIME) was administered to Kenyan youth between the ages of 14 and 29. 182 completed both the SIPS and mPRIME. Validation measures (sensitivity, specificity, positive predictive value, negative predictive value) were calculated and the study sample was then broken down into true positives, false positives, and false negatives for comparison on different quantitative measures. Results Using previously suggested thresholds for a positive screen, the mPRIME had a sensitivity of 40% and a specificity of 64.8% for our entire sample. Positive predictive value (PPV) and negative predictive value (NPV) were 12.3% and 89.7%, respectively. Breaking the sample down by questionnaire outcome showed that true-positive individuals scored higher on average rate and intensity of endorsement of mPRIME items compared to false-positive and false-negatives, while false-negatives on average registered disagreement on all mPRIME questionnaire items. Conclusions The mPRIME does not appear to be an effective screener of at-risk individuals for psychosis in our non-clinical sample. Further validation efforts in other general populations are warranted.

Validation of the Korean version of the 16-Item Prodromal Questionnaire in a Non-Help-Seeking College Population

“…In this study, PPVs were relatively low for a predictable screening tool [ 27 , 28 ]. This result may be explained by the observation that PPVs were relatively high in studies of selected help-seeking samples visiting specialized prodrome clinics and community mental health clinics [ 27 , 28 ], and low in studies of subjects with no help-seeking behavior, similar to ours [ 19 , 29 , 30 ]. Therefore, investigators who wish to increase the PPV of the KPQ-16 may use a higher cutoff score, which would lower the false-positive rate and sensitivity.…”

Identification of patients with recent-onset psychosis in KwaZulu Natal, South Africa: a pilot study with traditional health practitioners and diagnostic instruments

“…Endorsement of positive items of the CAPE may reflect distress or affective dysregulation rather than psychosis risk. It may also be argued that the items of the CAPE should have been adapted to the local culture, but a study of a similar screening instrument that was culturally adapted, reported a poor sensitivity and a low positive predictive value of psychosis risk in Kenyan young adults [29]. We intended to use the CAPE for screening purposes in a subsequent incidence study of psychotic disorders in Vulindlela, in order to enrich the sample and reduce the number of individuals needing indepth diagnostic interviews.…”

A comparative study of psychotic and affective symptoms in Rwandan and Kenyan students

“…Assessing clinical risk early has significantly advanced the possibility of indicated prevention of full-blown psychotic disorders (Yung et al 1996(Yung et al , 2004Miller et al 1999). Our group has conducted multiple studies in Kenya, investigating the prevalence of PLEs and risk for developing illness using self-report questionnaires (Mamah et al , 2013Ndetei et al 2012;Owoso et al 2014). The Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen ) was developed to overcome some of the challenges in assessing risk of developing psychotic disorders, guided by the existing literature on risk assessment and our previous efforts in Africa and the USA.…”