• Tablet-based screening doubles detection

    From ScienceDaily@1:317/3 to All on Mon Feb 20 21:30:30 2023
    Tablet-based screening doubles detection of psychosis symptoms in youth


    Date:
    February 20, 2023
    Source:
    University of California - Davis Health
    Summary:
    Asking patients to take a short survey on a tablet before their
    appointments may help mental health providers identify young
    people at risk of psychosis. A study found that when patients
    took a 21-question pre-visit survey, more than twice as many were
    identified at risk of psychosis compared to those who did not
    complete the survey. According to the National Institute of Mental
    Health, psychosis often begins when a person is in his or her late
    teens to mid-twenties. About 100,000 new cases of psychosis are
    diagnosed each year in the U.S.


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    FULL STORY ========================================================================== Asking patients to take a short survey on a tablet before their
    appointments may help mental health providers identify young people at
    risk of psychosis. A UC Davis Health study found that when patients took
    a 21-question pre-visit survey, more than twice as many were identified
    at risk of psychosis compared to those who did not complete the survey.


    ==========================================================================
    But despite the improvement in detecting individuals at risk, the
    technology- based screening did not reduce the time between the
    participants' first psychotic symptoms and when they received treatment.

    The findings are in a new UC Davis Health study published in JAMA
    Psychiatry.

    Previous studies have shown that the longer the time between the first psychotic incident -- such as hallucinations or delusions -- and receiving treatment, the more severe the course of the disease. According to the
    National Institute of Mental Health, psychosis often begins when a person
    is in his or her late teens to mid-twenties. About 100,000 new cases of psychosis are diagnosed each year in the U.S.

    "The addition of a brief screener at the initial evaluation can make a
    dramatic difference in clinical decision-making, helping you to realize
    that an individual needs specialized care," said Tara A. Niendam, first
    author of the study. Niendam is a professor and executive director of
    the UC Davis Health Early Psychosis Programs.

    Methods Data came from ten community clinics and four school sites. Sites
    were divided by those that used tablets for screening ("active screening")
    and those that screened using clinical judgment ("treatment as usual").

    For the sites with active screening, individuals between the ages of 12
    and 30 completed a questionnaire on a tablet before their visit with a
    mental health care provider.

    Known as the PQ-B (Prodromal Questionnaire, Brief Version), questions
    included "Do familiar surroundings sometimes seem strange, confusing, threatening or unreal to you?" and "Have you seen things that other
    people can't see or don't seem to see?" If the questionnaire score was
    20 or above, the participant was offered a referral to an early psychosis clinic for further evaluation.

    Sites not using active screening relied on clinical judgment for further evaluation and referrals to early psychosis clinics.

    Results The researchers evaluated data from 2,432 individuals at the active-screening sites and 2,455 at the treatment-as-usual sites.

    Active-screening sites reported a significantly higher detection rate
    of psychosis spectrum disorders, with 136 cases (5.6%), compared to 65
    (2.6%) in the sites that did not use the tablet screening.

    The active-screening sites also referred 13 individuals with first-episode psychosis compared to four in the sites that did not use active screening.

    But despite the early detection, the data showed no statistically
    significant difference in the duration of untreated psychosis. The mean
    for the active screening group was 239 days. The mean was 262.3 for the treatment-as-usual group.

    The researchers noted this was likely due to multiple factors leading
    to delayed access to the mental health system in the U.S.

    "On average, our participants experienced untreated psychosis for
    approximately six months before presenting at one of our participating
    clinic sites," said Mark Savill, assistant professor in the Department
    of Psychiatry and Behavioral Sciences and a co-author of the study. "A multifaceted approach that focuses on supporting individuals to seek
    help quicker and improving the pathway to appropriate services once they present for care may be necessary to achieve meaningful reductions in
    the duration of untreated psychosis." Young people at risk are not
    being identified Twenty-four sites agreed to participate. However,
    only ten community clinics and four school sites were able to fully
    implement the screening. Some study sites, such as primary care clinics,
    faced challenges implementing the screenings and reporting feedback;
    schools struggled with staffing issues and parent engagement.

    The setbacks highlight some of the challenges that might be faced scaling
    up programs that offer the active screening. But the results highlight
    how many young people at risk of psychosis are not being identified with
    the current system.

    "Population-based screening for psychosis has not been addressed
    systematically in the U.S. prior to this study," said Cameron S. Carter,
    senior author of the paper. Carter is a distinguished professor of
    psychiatry and psychology and director of the UC Davis Health Imaging
    Research Center and the Behavioral Health Center for Excellence.

    "Our increased identification of cases using the PQ-B questionnaire
    is an important finding. More people in this active group are getting
    into care," Carter said. "That's important because we know from previous research that individuals who are identified and receive treatment at the
    very early stages in their illness are likely to have the best outcomes."
    If you or a loved one think you may be experiencing symptoms of psychosis,
    the Early Psychosis Programs at UC Davis Health offer a free online
    screening survey.

    Additional authors on the study includeTyler A. Lesh, Daniel Ragland,
    Khalima Bolden, Haley Skymba, Sarah Gobrial, Monet Meyer, Katherine
    Pierce, Adi Rosenthal, Taylor Fedechko, Laura Tully, Valerie Tryon,
    Rosemary Cress and Richard Kravitz from UC Davis; Rachel Loewy and Kevin Delucchi from UCSF; and Howard Goldman from University of Maryland,
    Baltimore.

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    ========================================================================== Story Source: Materials provided by
    University_of_California_-_Davis_Health. Original written by Lisa
    Howard. Note: Content may be edited for style and length.


    ========================================================================== Journal Reference:
    1. Tara A. Niendam, Rachel Loewy, Mark Savill, Kevin L. Delucchi,
    Tyler A.

    Lesh, J. Daniel Ragland, Khalima Bolden, Haley V. Skymba, Sarah
    Gobrial, Monet S. Meyer, Katherine M. Pierce, Adi Rosenthal, Taylor
    L. Fedechko, Laura M. Tully, Valerie L. Tryon, Howard Goldman,
    Rosemary D. Cress, Richard L. Kravitz, Cameron S. Carter. Effect
    of Technology-Enhanced Screening in Addition to Standard Targeted
    Clinician Education on the Duration of Untreated Psychosis. JAMA
    Psychiatry, 2023; 80 (2): 119 DOI: 10.1001/jamapsychiatry.2022.4436 ==========================================================================

    Link to news story: https://www.sciencedaily.com/releases/2023/02/230220121906.htm

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