Psychosis risk screening in routine mental health care

Background: Routine screening for psychosis risk in mental health care is not common practice. However, a systematic screening process might allow for the identification and treatment of UHR patients to prevent or delay psychosis. Furthermore, it may aid reducing DUP of undetected patients with a psychosis. But, is it possible to apply the criteria for ultra high risk for psychosis in populations with lower a priori probability of psychosis? Method: We used a two-stage screening procedure to screen all consecutive young adults, aged 18-35 years, who were help-seeking for nonpsychotic disorders (n = 3533) at the secondary mental health services in the Hague with a 16-item version of the Prodromal Questionnaire. Results: In the general help-seeking population, a cut-off score of 6 or more positively answered items on the 16-item version of the PQ has a high true positive rate (87%) and high specificity (87%) when differentiating UHR/psychosis from those with no Comprehensive Assessment of At-Risk Mental States (Yung et al., 2005) diagnosis. Conclusion: Young people with attenuated psychotic symptoms can be reliably identified in a general help-seeking population. The PQ-16 is recommended as routine screening tool in mental health care settings because it is feasible to screen large help-seeking populations