Specificity and sensitivity of the Beck Hopelessness Scale for suicidal ideation among adolescents entering early intervention service.

Previous studies have shown an association between hopelessness and suicidal behaviour in clinical populations. The aim of the study was to investigate sensitivity, specificity, and predictive validity of the Beck Hopelessness Scale (BHS) for suicidal ideation in adolescents who show early risk signs on the psychiatric disorder continuum. Three-hundred and two help-seeking adolescents (mean age = 15.5 years) who were entering an early intervention team at Helsinki University Central Hospital, Finland, completed questionnaires of BHS and suicidal ideation, derived from Beck Depression Inventory (BDI-II). Results suggest that a BHS cut-off score ≥8 (sensitivity = 0.70, specificity = 0.76) or cut-off score ≥9 (sensitivity = 0.63, specificity = 0.80) may be useful to detect suicidal ideation with BHS in help-seeking adolescents population. Results remain mainly the same in a separate analysis with adolescents at risk for psychosis. The results support previous cut-off points for BHS in identification of suicidal ideation. The results suggest also that lower cut-off scores may be useful in sense of sensitivity, especially in clinical settings.

Discrepancy between self-reported and interviewed psychosis risk symptoms: auditory distortions are the most reliably reported symptom by self-report.

AIM: In the recent literature, there has been growing interest in assessment methods for detecting increased risk of developing psychosis. Self-report methods are popular but may lead to different results compared to clinical interviews. METHODS: The difference in psychosis risk scores was tested between self-reported psychosis risk symptoms (PROD-SR) and self-reported symptoms additionally confirmed by interview (PROD-SR + I). The symptom categories were derived from 12 common psychosis risk symptoms included in the PROD screening instrument. The data were collected by questionnaires and interviews conducted with 395 adolescents (mean age 15.3 years) in an early intervention and detection team, JERI, at Helsinki University Central Hospital, Finland. RESULTS: The results show a significant difference between the PROD-SR risk symptom sum scores and the PROD-SR + I risk symptom sum scores (N = 395; Z = -15.123; P < 0.001). In an item-by-item analysis, the item 'Disorders in connection with hearing' had the strongest kappa value (0.827) agreement between an interviewed and self-report psychosis risk item. Agreement in most items remained between slight and substantial (kappa values from 0.082 to 0.649). CONCLUSIONS: The results suggest that there is a significant difference between psychosis risk symptom responses collected by self-report and self-report responses which are additionally confirmed by interview. Auditory disorders are the most reliably reported item with self-report.

Early signs of worry: psychosis risk symptom visual distortions are independently associated with suicidal ideation.

Previous studies have shown an association between suicidal behavior and schizophrenia. However, little is known about this association in those with psychotic experiences and symptoms that do not meet the criteria for full psychosis. The aim of the study was to investigate how psychosis risk symptoms are associated with suicidal ideation. Three-hundred and nine help-seeking adolescents (mean age 15.5 years) who were screened by an early intervention and detection team JERI in Helsinki University Central Hospital, Finland, were interviewed and asked to complete questionnaires of psychosis risk symptoms, suicidal ideation and depression. Psychosis risk symptoms were assessed by self-report and confirmed by interview with questions from PROD-screen, depression was measured with BDI-II questionnaire and suicidal ideation was derived from BDI-II questionnaire. In a logistic regression analysis psychosis risk symptom visual distortions explained independently (OR 4.33; 95% CI 1.28-14.64) suicidal ideation when age, gender, depression and psychosis risk symptoms thought disorders, persecuting feelings and auditory distortions were controlled for. Results suggest that visual distortions are independently associated with suicidal ideation in young people. This finding should be taken into account in assessing help-seeking adolescents.

Lower functioning predicts identification of psychosis risk screening status in help-seeking adolescents.

AIM: There is some previous evidence suggesting that the risk state for psychosis is associated with decreased functioning ability, health-related quality of life (QoL), anxiety and depression. The aim of this study is to identify which factors predict psychosis risk screening status. METHODS: The data were collected in Helsinki University Central Hospital, Finland, by an early intervention team. One hundred eighty-one help-seeking adolescents (mean age 15.3 years) completed questionnaires of QoL (16D), alcohol consumption (Alcohol Use Disorders Identification Test), anxiety (Beck Anxiety Inventory), hopelessness (BBeck Hopelessness Scale) and depression (Beck Depression Inventory II). Functioning ability was assessed by the Global Assessment of Functioning, whereas the PROD-screen was used to interview and assess risk symptoms for psychosis. RESULTS: In a logistic regression analysis, a lower functioning ability explained independently (P = 0.006) psychosis risk screening status after age, gender, alcohol consumption, QoL, anxiety, hopelessness and depression symptoms were adjusted. CONCLUSIONS: The present results suggest that lower functioning ability is associated independently with psychosis risk screening status. Hence, therapeutic input for those at risk should focus upon improving functioning.