ABSTRACT
BACKGROUND: Clinical sub-groups of schizophrenia, namely drug related, traumatic, anxiety and stress sensitivity sub-types, have been proposed for use in research, training and practice. They were developed on the basis of clinical observation but have not yet been used in research or clinical practice to any great extent. AIMS: To develop a semi-structured clinical interview for psychosis sub-groups (SCIPS) and determine the best diagnostic criteria with the highest inter-rater reliability, test-retest reliability and concurrent validity for sub-grouping patients with schizophrenia according to a newly developed classification scheme. METHODS: The SCIPS was developed based upon discussion with the clinician researchers who had developed and were using the sub-groups. Kappa coefficients were calculated between two independent diagnostic assessments with the SCIPS (for inter-rater reliability and test-retest reliability, n = 20) and between the SCIPS diagnosis and the sub-groupings as determined independently with highest achievable validity (for concurrent validity, n = 21) for patients with schizophrenia. These inter-rater reliability and concurrent validity were compared among five different sets of diagnostic criteria to determine which was most reliable and valid. RESULTS: A set of diagnostic criteria with the highest inter-rater reliability and concurrent validity was determined. Kappa coefficients (95% confidence interval) for the inter-rater reliability and concurrent validity were 0.93 (0.66-1.20) and 0.73 (0.47-1.00), respectively, with these diagnostic criteria. CONCLUSIONS: The SCIPS is a promising tool with which to sub-group patients with schizophrenia according to this recently developed classification scheme. The semi-structured interview achieves acceptable inter-rater and test-retest reliability and concurrent validity.
Subject(s)
Borderline Personality Disorder/diagnosis , Interview, Psychological , Mental Disorders/diagnosis , Psychometrics/standards , Schizophrenia/diagnosis , Surveys and Questionnaires , Adolescent , Adult , Aged , Borderline Personality Disorder/epidemiology , Borderline Personality Disorder/ethnology , Eligibility Determination , Female , Guidelines as Topic , Humans , Life Change Events , Male , Mental Disorders/classification , Mental Disorders/epidemiology , Middle Aged , Patient Selection , Psychiatric Status Rating Scales , Psychometrics/organization & administration , Reproducibility of Results , Schizophrenia/epidemiology , Schizophrenia/ethnology , Sensitivity and Specificity , United Kingdom/epidemiologyABSTRACT
PURPOSE: A number of recent studies suggest that delusions may be explained as a continuum from normal beliefs. Fear of negative evaluation from others (FNE) is one of potential factors that might describe this psychological process of delusions. METHODS: In order to examine whether FNE is associated with delusional ideation in both non-clinical population and patients with schizophrenia, two sets of data [from a non-clinical student sample (n = 282) and from patients with schizophrenia (n = 117)] were collected to examine whether Brief Fear of Negative Evaluation Scale (BFNE) score and the 21-item Peters Delusions Inventory (PDI-21) score were associated with each other. Linear regression analyses were carried out to assess if the BFNE score still remained associated with the PDI-21 scores once the confounding effects of depression were controlled. RESULTS: BFNE scores were significantly related to PDI-21 scores in both non-clinical [Pearson product-moment correlation coefficient (r) = 0.37, 95% confidence Interval (CI) = 0.25-0.48] and patient (r = 0.33, 95% CI = 0.14-0.49) samples. These associations were still significant when confounding effects of depression were controlled. Standardised coefficients for the BFNE scores in the linear regression model were 0.21 in the student sample and 0.19 in the clinical sample. CONCLUSIONS: FNE was associated with delusional ideation both in non-clinical population and in patients with schizophrenia. FNE might be a potential target for both pharmacological and psychological interventions for patients with delusions.