Screening for Psychotic Experiences and Psychotic Disorders in General Mental Health Treatment Settings: A Systematic Review and Meta-Analysis.

IF 2.5 4区 医学 Q2 PSYCHIATRY
Jacqueline A Clauss, Cheryl Y S Foo, Catherine J Leonard, Katherine N Dokholyan, Corinne Cather, Daphne J Holt
{"title":"Screening for Psychotic Experiences and Psychotic Disorders in General Mental Health Treatment Settings: A Systematic Review and Meta-Analysis.","authors":"Jacqueline A Clauss, Cheryl Y S Foo, Catherine J Leonard, Katherine N Dokholyan, Corinne Cather, Daphne J Holt","doi":"10.1097/HRP.0000000000000419","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The absence of systematic psychosis screening within general mental health services contributes to substantial treatment delays and poor long-term outcomes for individuals with psychotic symptoms. We conducted a meta-analysis to estimate rates of subclinical psychotic symptoms for psychotic experiences (PE), clinical high-risk for psychosis syndrome (CHR-P), and psychotic disorders that were identified via studies screening treatment-seeking individuals. These rates can inform implementation recommendations for routine psychosis screening in general mental health settings.</p><p><strong>Methods: </strong>PubMed and Web of Science databases were searched to identify empirical studies with information on PE, CHR-P, or psychotic disorder prevalence identified by screening inpatients and outpatients (age < 65 years) receiving general mental health care. PE was identified using threshold scores on validated self-reported questionnaires, and CHR-P and psychotic disorder were identified using gold-standard structured interview assessments. A meta-analysis of each outcome was conducted using the restricted maximum likelihood estimator method to assess effect sizes in a random effects model.</p><p><strong>Results: </strong>The analyses included 41 independent samples (k = 32 outpatient, k = 2 inpatient, k = 7 combined settings) with a total of 25,751 patients (58% female, mean age: 24.1 years). PE prevalence was 44.3% (95% CI: 35.8-52.8%; 28 samples, n = 21,957); CHR-P prevalence was 26.4% (95% CI: 20.0-32.7%; 28 samples, n = 14,395); and psychotic disorder prevalence was 6.6% (95% CI: 3.3-9.8%; 32 samples, n = 20,371). Rates did not differ by sex, age, or setting type.</p><p><strong>Conclusions: </strong>The high prevalence of psychotic symptoms in general mental health treatment settings underscores the need for early-detection psychosis screening. These base rates can be used to plan training and allocation of resources required to conduct psychosis assessments and build capacity for delivering interventions for CHR-P and early psychosis in non-specialty mental health treatment settings.</p>","PeriodicalId":12915,"journal":{"name":"Harvard Review of Psychiatry","volume":" ","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Harvard Review of Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/HRP.0000000000000419","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: The absence of systematic psychosis screening within general mental health services contributes to substantial treatment delays and poor long-term outcomes for individuals with psychotic symptoms. We conducted a meta-analysis to estimate rates of subclinical psychotic symptoms for psychotic experiences (PE), clinical high-risk for psychosis syndrome (CHR-P), and psychotic disorders that were identified via studies screening treatment-seeking individuals. These rates can inform implementation recommendations for routine psychosis screening in general mental health settings.

Methods: PubMed and Web of Science databases were searched to identify empirical studies with information on PE, CHR-P, or psychotic disorder prevalence identified by screening inpatients and outpatients (age < 65 years) receiving general mental health care. PE was identified using threshold scores on validated self-reported questionnaires, and CHR-P and psychotic disorder were identified using gold-standard structured interview assessments. A meta-analysis of each outcome was conducted using the restricted maximum likelihood estimator method to assess effect sizes in a random effects model.

Results: The analyses included 41 independent samples (k = 32 outpatient, k = 2 inpatient, k = 7 combined settings) with a total of 25,751 patients (58% female, mean age: 24.1 years). PE prevalence was 44.3% (95% CI: 35.8-52.8%; 28 samples, n = 21,957); CHR-P prevalence was 26.4% (95% CI: 20.0-32.7%; 28 samples, n = 14,395); and psychotic disorder prevalence was 6.6% (95% CI: 3.3-9.8%; 32 samples, n = 20,371). Rates did not differ by sex, age, or setting type.

Conclusions: The high prevalence of psychotic symptoms in general mental health treatment settings underscores the need for early-detection psychosis screening. These base rates can be used to plan training and allocation of resources required to conduct psychosis assessments and build capacity for delivering interventions for CHR-P and early psychosis in non-specialty mental health treatment settings.

筛查精神病经历和精神病障碍在一般心理健康治疗设置:系统回顾和荟萃分析。
背景:在普通精神卫生服务中缺乏系统的精神病筛查会导致大量的治疗延误和精神病症状个体的不良长期预后。我们进行了一项荟萃分析,以估计精神病经历(PE)的亚临床精神病症状、精神病综合征的临床高风险(chrp)和通过研究筛选寻求治疗的个体而确定的精神障碍的发生率。这些比率可以为一般精神卫生机构的常规精神病筛查的实施建议提供信息。方法:检索PubMed和Web of Science数据库,通过筛选接受普通精神卫生保健的住院和门诊患者(年龄< 65岁),确定PE、chrp或精神障碍患病率的实证研究。PE采用有效的自我报告问卷的阈值评分进行鉴定,chrp和精神障碍采用金标准结构化访谈评估进行鉴定。使用限制性最大似然估计方法对每个结果进行荟萃分析,以评估随机效应模型中的效应大小。结果:分析包括41个独立样本(k = 32门诊,k = 2住院,k = 7联合设置),共25,751例患者(58%女性,平均年龄:24.1岁)。PE患病率为44.3% (95% CI: 35.8-52.8%;28个样本,n = 21,957);CHR-P患病率为26.4% (95% CI: 20.0-32.7%;28个样本,n = 14,395);精神障碍患病率为6.6% (95% CI: 3.3-9.8%;32个样本,n = 20,371)。发病率没有因性别、年龄或设置类型而异。结论:精神病症状在普通精神卫生治疗机构的高患病率强调了早期发现精神病筛查的必要性。这些基本比率可用于规划进行精神病评估所需的培训和资源分配,并建立在非专业精神卫生治疗环境中提供chrp和早期精神病干预措施的能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
7.50
自引率
0.00%
发文量
67
审稿时长
>12 weeks
期刊介绍: The Harvard Review of Psychiatry is the authoritative source for scholarly reviews and perspectives on important topics in psychiatry. Founded by the Harvard Medical School''s Department of Psychiatry, the Harvard Review of Psychiatry features review papers that summarize and synthesize the key literature in a scholarly and clinically relevant manner. Topics covered include: Schizophrenia and related disorders; Mood disorders; Personality disorders; Substance use disorders; Anxiety; Neuroscience; Psychosocial aspects of psychiatry; Ethics; Psychiatric education; and much more. In addition, a Clinical Challenges section presents a case with discussion from a panel of experts. Brief reviews are presented in topic-specific columns that include Cross-Cultural Psychiatry, History of Psychiatry, Ethics, and others.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信