Relevant bibliographies by topics / Comprehensive Assessment of At-Risk Mental States (CAARMS)

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Academic literature on the topic 'Comprehensive Assessment of At-Risk Mental States (CAARMS)'

Author: Grafiati
Published: 4 June 2021
Last updated: 2 February 2022

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Journal articles on the topic "Comprehensive Assessment of At-Risk Mental States (CAARMS)"

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Yung, Alison R., Alison R. Yung, Hok Pan Yuen, Patrick D. Mcgorry, Lisa J. Phillips, Daniel Kelly, Margaret Dell'olio, et al. "Mapping the Onset of Psychosis: The Comprehensive Assessment of At-Risk Mental States." Australian & New Zealand Journal of Psychiatry 39, no. 11-12 (November 2005): 964–71. http://dx.doi.org/10.1080/j.1440-1614.2005.01714.x.

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Objective: Recognizing the prodrome of a first psychotic episode prospectively creates the opportunity of intervention, which could delay, ameliorate or even prevent onset. Valid criteria and a reliable methodology for identifying possible prodromes are needed. This paper describes an instrument, the Comprehensive Assessment of At-Risk Mental States (CAARMS), which has been designed for such a purpose. It has two functions: (i) to assess psychopathology thought to indicate imminent development of a first-episode psychotic disorder; and (ii) to determine if an individual meets criteria for being at ultra high risk (UHR) for onset of first psychotic disorder. This paper describes the pilot evaluation of the CAARMS. Method: Several methodologies were used to test the CAARMS. First, CAARMS scores in a group of UHR young people and the association between CAARMS scores and the risk of transition to psychotic disorder, were analysed. Second, CAARMS scores in a UHR group were compared to a control group. To assess concurrent validity, CAARMS-defined UHR criteria were compared to the existing criteria for identifying the UHR cohort. To assess predictive validity, the CAARMS-defined UHR criteria were applied to a sample of 150 non-psychotic help-seekers and rates of onset of psychotic disorder at 6-month follow-up determined for the CAARMS-positive (i.e. met UHR criteria) group and the CAARMS-negative (i.e. did not meet UHR criteria) group. The inter-rater reliability of the CAARMS was assessed by using pairs of raters. Results: High CAARMS score in the UHR group was significantly associated with onset of psychotic disorder. The control group had significantly lower CAARMS scores than the UHR group. The UHR criteria assessed by the CAARMS identified a similar group to the criteria measured by existing methodology. In the sample of non-psychotic help-seekers those who were CAARMS-positive were at significantly increased risk of onset of psychotic disorder compared to those who were CAARMS-negative (relative risk of 12.44 (95% CI=1.5–103.41, p=0.0025)). The CAARMS had good to excellent reliability. Conclusions: In these preliminary investigations, the CAARMS displayed good to excellent concurrent, discriminant and predictive validity and excellent inter-rater reliability. The CAARMS instrument provides a useful platform for monitoring sub threshold psychotic symptoms for worsening into full-threshold psychotic disorder.
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Oliver, D., M. Kotlicka-Antczak, A. Minichino, G. Spada, P. McGuire, and P. Fusar-Poli. "Meta-analytical prognostic accuracy of the Comprehensive Assessment of at Risk Mental States (CAARMS): The need for refined prediction." European Psychiatry 49 (2018): 62–68. http://dx.doi.org/10.1016/j.eurpsy.2017.10.001.

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AbstractPrimary indicated prevention is reliant on accurate tools to predict the onset of psychosis. The gold standard assessment for detecting individuals at clinical high risk (CHR-P) for psychosis in the UK and many other countries is the Comprehensive Assessment for At Risk Mental States (CAARMS). While the prognostic accuracy of CHR-P instruments has been assessed in general, this is the first study to specifically analyse that of the CAARMS. As such, the CAARMS was used as the index test, with the reference index being psychosis onset within 2 years. Six independent studies were analysed using MIDAS (STATA 14), with a total of 1876 help-seeking subjects referred to high risk services (CHR-P+: n = 892; CHR-P–: n = 984). Area under the curve (AUC), summary receiver operating characteristic curves (SROC), quality assessment, likelihood ratios, and probability modified plots were computed, along with sensitivity analyses and meta-regressions. The current meta-analysis confirmed that the 2-year prognostic accuracy of the CAARMS is only acceptable (AUC = 0.79 95% CI: 0.75–0.83) and not outstanding as previously reported. In particular, specificity was poor. Sensitivity of the CAARMS is inferior compared to the SIPS, while specificity is comparably low. However, due to the difficulties in performing these types of studies, power in this meta-analysis was low. These results indicate that refining and improving the prognostic accuracy of the CAARMS should be the mainstream area of research for the next era. Avenues of prediction improvement are critically discussed and presented to better benefit patients and improve outcomes of first episode psychosis.
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Yung, A. R., H. P. Yuen, L. J. Phillips, S. Francey, and P. D. McGorry. "Mapping the onset of psychosis: The comprehensive assessment of at risk mental states (CAARMS)." Schizophrenia Research 60, no. 1 (March 2003): 30–31. http://dx.doi.org/10.1016/s0920-9964(03)80090-7.

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Nelson, B., A. R. Yung, S. M. Francey, and P. D. McGorry. "0264 ASSESSING THOSE AT HIGH RISK OF PSYCHOTIC DISORDER USING THE COMPREHENSIVE ASSESSMENT OF AT RISK MENTAL STATES (CAARMS)." Schizophrenia Research 86 (October 2006): S79. http://dx.doi.org/10.1016/s0920-9964(06)70234-1.

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Valmaggia, L. R., D. Stahl, A. R. Yung, B. Nelson, P. Fusar-Poli, P. D. McGorry, and P. K. McGuire. "Negative psychotic symptoms and impaired role functioning predict transition outcomes in the at-risk mental state: a latent class cluster analysis study." Psychological Medicine 43, no. 11 (February 27, 2013): 2311–25. http://dx.doi.org/10.1017/s0033291713000251.

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BackgroundMany research groups have attempted to predict which individuals with an at-risk mental state (ARMS) for psychosis will later develop a psychotic disorder. However, it is difficult to predict the course and outcome based on individual symptoms scores.MethodData from 318 ARMS individuals from two specialized services for ARMS subjects were analysed using latent class cluster analysis (LCCA). The score on the Comprehensive Assessment of At-Risk Mental States (CAARMS) was used to explore the number, size and symptom profiles of latent classes.ResultsLCCA produced four high-risk classes, censored after 2 years of follow-up: class 1 (mild) had the lowest transition risk (4.9%). Subjects in this group had the lowest scores on all the CAARMS items, they were younger, more likely to be students and had the highest Global Assessment of Functioning (GAF) score. Subjects in class 2 (moderate) had a transition risk of 10.9%, scored moderately on all CAARMS items and were more likely to be in employment. Those in class 3 (moderate–severe) had a transition risk of 11.4% and scored moderately severe on the CAARMS. Subjects in class 4 (severe) had the highest transition risk (41.2%), they scored highest on the CAARMS, had the lowest GAF score and were more likely to be unemployed. Overall, class 4 was best distinguished from the other classes on the alogia, avolition/apathy, anhedonia, social isolation and impaired role functioning.ConclusionsThe different classes of symptoms were associated with significant differences in the risk of transition at 2 years of follow-up. Symptomatic clustering predicts prognosis better than individual symptoms.
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Miyakoshi, Tetsuo, Kazunori Matsumoto, Fumiaki Ito, Noriyuki Ohmuro, and Hiroo Matsuoka. "Application of the Comprehensive Assessment of At-Risk Mental States (CAARMS) to the Japanese population: reliability and validity of the Japanese version of the CAARMS." Early Intervention in Psychiatry 3, no. 2 (May 2009): 123–30. http://dx.doi.org/10.1111/j.1751-7893.2009.00118.x.

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Yung, A. R., L. E. O'Dwyer, S. M. Francey, M. B. Simmons, and B. Nelson. "0553 ASSESSING THOSE AT HIGH RISK OF PSYCHOTIC DISORDER –AN EXPERIENTIAL WORKSHOP USING THE COMPREHENSIVE ASSESSMENT OF AT RISK MENTAL STATES (CAARMS)." Schizophrenia Research 86 (October 2006): S82. http://dx.doi.org/10.1016/s0920-9964(06)70244-4.

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Pelizza, Lorenzo, Federica Paterlini, Silvia Azzali, Sara Garlassi, Ilaria Scazza, Simona Pupo, Magenta Simmons, Barnaby Nelson, and Andrea Raballo. "The approved Italian version of the comprehensive assessment of at-risk mental states (CAARMS-ITA): Field test and psychometric features." Early Intervention in Psychiatry 13, no. 4 (April 26, 2018): 810–17. http://dx.doi.org/10.1111/eip.12669.

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Kim, Sung-Wan, Jae-Kyeong Kim, Ji Hun Han, Min Jhon, Ju-Wan Kim, Ju-Yeon Lee, Jae-Min Kim, et al. "Validation of the Korean Version of the 15-Item Community Assessment of Psychic Experiences in a College Population." Psychiatry Investigation 17, no. 4 (April 15, 2020): 306–11. http://dx.doi.org/10.30773/pi.2019.0215.

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Objective To investigate the reliability and validity of the Korean version of the Community Assessment of Psychic Experiences-15 item positive scale (CAPE-15) in college students.Methods This study had two stages: initial screening with self-report questionnaires including the CAPE-15, and semi-structured interviews to investigate the instrument’s diagnostic validity. The initial screening involved 1,749 college students. The modified Korean version of Prodromal Questionnaire-16 item (mKPQ-16) was also administered. The criteria for ultra-high risk (UHR) of psychosis in the Comprehensive Assessment of At-Risk Mental States (CAARMS) were the gold standard for diagnosis.Results Twelve of the interviewed subjects met the CAARMS criteria for UHR of psychosis. The area under the receiver operating characteristic curve was highest (0.936) for the CAPE-15 distress score (p<0.001). The use of 6 as the cutoff for the CAPE-15 distress score resulted in the best balance of sensitivity (91.7%) and specificity (85.2%), with a favorable positive predictive value of 32.4%. The coefficients of correlation between the CAPE-15 and mKPQ-16 were significant.Conclusion The Korean version of the CAPE-15 is a good instrument for screening for psychosis risk in collegiate settings. The validation of this scale could contribute to the early identification of psychosis in the Korean community.
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Whitney, Daniel, and Stephen Wright. "A retrospective case-control service evaluation of CAARMS scores of patients with autism in York EIP, compared to age matched controls." BJPsych Open 7, S1 (June 2021): S59—S60. http://dx.doi.org/10.1192/bjo.2021.203.

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AimsStudies show the prevalence of Autism Spectrum Conditions in Early Intervention in Psychosis (EIP) populations is 3.6-3.7%, compared to approximately 1-1.5% in the general population. The CAARMS (Comprehensive Assessment of At Risk Mental States) is a national tool used by EIP services as a screening tool to bring patients into services and stratify their symptoms to determine what pathway may be most appropriate (First Episode Psychosis pathway (FEP) or At Risk Mental State pathway (ARMS)). As far as we are aware the CAARMS has not been validated in an autistic population. It is our view that several of the questions in the CAARMS may be interpreted differently by people with autism, thus affecting the scores. The aim of this evaluation was to identify whether CAARMS scores differ between patients diagnosed with autism and matched controls in York EIP.MethodFrom their mental health records, we identified all patients in the service with a diagnosis of autism. We then compared the CAARMS scores, at the time of referral, to those of age matched controls (matched by being in the age range 16-30) without an autism diagnosis, using continuous sampling by date of referral.Result14 patients in the service had a diagnosis of autism and had completed a CAARMS. CAARMS domains are all scored between 0 and 6 (indicating increasing severity or frequency). Compared to the age matched controls, autistic patients had a higher mean difference in their scores for ‘Non-Bizarre Ideas’ (mean difference of 0.86 for severity and 0.57 for frequency) and ‘Disorganised Speech’ (mean difference of 0.28 for severity and 0.57 for frequency). These results did not reach statistical significance which was unsurprising given the sample size. The gender split between groups was similar.ConclusionOur evaluation suggests a difference in CAARMS scores between patients in our service with a diagnosis of autism and those without. A larger study would be needed to confirm a statistically significant difference and multicentre results would be needed as evidence of generalisability. However, if such a difference were confirmed it might question the validity of CAARMS in autistic patients or suggest that modifications, perhaps in the form of reasonable adjustments to the questions or scoring, were needed to increase the validity in this population. We would suggest that spending extra time checking the patient has understood the intended meaning of the questions in the CAARMS may increase validity, particularly in the ‘Non-Bizarre Ideas’ domain.
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Dissertations / Theses on the topic "Comprehensive Assessment of At-Risk Mental States (CAARMS)"

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Assudani, H. A. "Culture and the Comprehensive Assessment of At Risk Mental States (CAARMS)." Thesis, University College London (University of London), 2014. http://discovery.ucl.ac.uk/1449521/.

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This thesis focused on the role of culture in psychotic symptom measures, and consists of three parts. Part 1 presents a systematic literature review on the reliability and validity of translated semi/structured interview measures of psychosis. Nineteen publications based on nine semi/structured interview measures of psychosis were reviewed and deemed to be of varying quality. The review highlights the intricacy of language translation and the necessity of the development of a quality assessment tool for studies focusing on psychometric properties of clinical measures. Part 2 is an empirical paper that investigated if clinicians’ familiarity with their client’s culture (i.e. cultural familiarity) predicts the accuracy of culturally mediated attenuated psychotic symptoms identified using the Comprehensive Assessment of At Risk Mental States (CAARMS). Three constructs of cultural familiarity were used - cultural knowledge, cultural similarity and cultural self-efficacy. Results suggest that cultural knowledge and cultural similarity predict one’s accuracy on culturally mediated attenuated psychotic symptoms utilising the CAARMS. Neither cultural self-efficacy, nor years of experience were predictors. Part 3 is a critical appraisal which reflects on how the researcher came to the research study and issues that arose during the research process. A discussion on culture and mental health problems was also included.
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Johnson, Caroline. "Clinical predictors in young help-seeking people referred to the Lancashire Early Assessment and Detection Clinic : a service evaluation." Thesis, University of Manchester, 2013. https://www.research.manchester.ac.uk/portal/en/theses/clinical-predictors-in-young-helpseeking-people-referred-to-the-lancashire-early-assessment-and-detection-clinic-a-service-evaluation(91a218c4-0554-46a1-a8da-f1312ec7b80d).html.

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Two main psychopathology-based approaches to detection of the prodrome have emerged; the Ultra High Risk (UHR) and Basic Symptom approaches. Conversion risk varies between studies using these approaches and in one centre conversion rates are reported to be decreasing year on year. There is a need examine the conversion risk across studies to establish a pooled estimate of risk for instruments designed to detect the prodrome of psychosis. To maximise the detection of those thought to present a risk of psychosis the Lancashire Early Assessment and Detection (LEAD) clinic uses an UHR instrument, the Comprehensive Assessment of at Risk Mental States (CAARMS) and A Basic Symptom instrument, the Schizophrenia Proneness Instrument (SPI-A). The thesis had two broad aims 1) to conduct a systematic review with meta-analysis of the research field to date and identify areas for further research, 2) to establish the accuracy of the LEAD clinic predictions. The meta-analysis involved a systematic search of MEDLINE, EMBASE, PsychINFO and CINHAL identifying studies of psychopathology-based instruments for the detection of the psychosis prodrome. The service evaluation examined for conversion to psychosis in patients examined for Basic Symptoms (SPI-A), attenuated positive symptoms (CAARMS), schizotypy (SPQ-A) and social functioning (SOFAS).The meta-analysis found that both the UHR and Basic Symptom approaches yield similar results. The differences in the positive predictive values (PPV) of the two approaches were not significant (Basic Symptoms, 0.34, UHR 0.25). The service evaluation found over a third (n=58) of referrals to the LEAD clinic to be psychotic at baseline and sixty-four patients to have an at risk mental state (ARMS). Conversion risk for CAARMS was 36.67%. and was 28.57% for SPI-A. The COGDIS criterion of SPI-A was found to be the most predictive with a PPV of 0.43, a sensitivity of 0.80. When patients met a combination of both COGDIS and CAARMS the likelihood ratio increased to 5.25 although the sensitivity was low (0.47).Overall, the findings of the thesis indicate that both the Basic Symptom and UHR approaches are valid for use in routine clinical settings for the assessment of psychosis risk. The thesis found that a combination of both approaches could provide future opportunities research. The SPQ-A schizotypy assessment was found to correlate with the attenuated symptom criterion of CAARMS and evidence suggests that the SPQ-A score increases closer to transition. The SPQ-A could offer opportunities for developing efficient methods of monitoring progression of prodromal symptoms.
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Book chapters on the topic "Comprehensive Assessment of At-Risk Mental States (CAARMS)"

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Batista, Sharon M., and Harold W. Goforth. "Diagnosis of Psychiatric Disorders." In Handbook of AIDS Psychiatry. Oxford University Press, 2010. http://dx.doi.org/10.1093/oso/9780195372571.003.0010.

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As we enter the third decade of the AIDS pandemic, persons with AIDS are living longer and healthier lives as a result of appropriate medical care and advances in antiretroviral therapy. In the United States and throughout the world, however, some men, women, and children with AIDS are unable to benefit from this medical progress because of inadequate access to care. A multiplicity of barriers involving economic, social, political, and psychiatric factors contribute to this lack of access. For this and other reasons, psychiatric factors take on new relevance and meaning in this stage of the pandemic (Cohen, 2008). Psychiatric disorders and distress play a significant role in the transmission of, exposure to, and infection with HIV. They are thus relevant to HIV prevention, clinical care, and adherence to treatment throughout every aspect of illness from the initial risk behavior to death. Psychiatric disorders can result in considerable suffering, from diagnosis to end-stage illness. Persons with HIV and AIDS may have no psychiatric diagnosis at all or any diagnosis described in psychiatric nomenclature (Cohen and Alfonso, 2004; Cohen, 2008). In this chapter, we provide guidelines for the diagnosis of those psychiatric disorders that are most likely to complicate and perpetuate the HIV pandemic and pose diagnostic dilemmas for clinicians. Although we introduce aspects of treatment of each disorder, please see Chapters 7, 8, 9, 10, 11, and 12 for detailed descriptions of psychotherapeutic and psychopharmacological treatment approaches to AIDS psychiatry. Consideration of a broad differential diagnosis is paramount in evaluating behavioral disorders in persons with HIV, especially when investigating medical and neuropsychiatric etiological factors related to HIV illness and its treatment. Since few persons with HIV have access to psychiatrists or other mental health clinicians, and even fewer have access to an AIDS psychiatrist, a summary of suggested key questions is provided here to aid HIV clinicians in detecting the underlying psychiatric diagnoses most frequently encountered in persons with HIV and AIDS. While these questions are by no means a substitute for comprehensive psychiatric evaluation (described in detail in Chapter 2 of this handbook), they can inform clinicians of the need for further assessment, emergency intervention, or referral to a psychiatrist.
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