Obsessive-compulsive symptoms in individuals at clinical high risk for psychosis: A 2-year longitudinal study.

Aim - Recent findings suggest that OCS are prevalent in individuals with early psychosis. However, their clinical relevance still needs to be clarified. This research specifically explored OCS in subjects at Clinical High Risk for Psychosis (CHRP), with the aims of determining their baseline prevalence, examining their 2-year stability, and analyzing their association with sociodemographic data, clinical characteristics and outcomes. Methods - Clinical assessments at baseline and during the 2-year follow-up period included: the Comprehensive Assessment of At-Risk Mental states (CAARMS), the Positive And Negative Syndrome Scale (PANSS), and the Global Assessment of Functioning (GAF). OCS were identified using the CAARMS item 7.6 subscore. Results - Among 180 CHR-P participants, 66 (36.7 %) had OCS at baseline. CHR-P with OCS had higher PANSS scores and greater antidepressant prescription rates. OCS severity levels improved in the first year, but plateaued over two years, correlating with longitudinal changes in GAF and PANSS total scores. OCS improvement was specifically associated with antidepressant use and intensity of individual psychotherapy sessions. CHR-P subjects with OCS had higher service engagement rates. Conclusions - The presence of OCS could characterize a distinct CHR-P subtype with specific clinical and prognostic characteristics, requiring tailored diagnostic and therapeutic approaches. Recognizing the heterogeneity in CHR-P population is crucial for optimizing care.

The Italian version of the 16-item prodromal questionnaire (iPQ-16): Field-test and psychometric features.

OBJECTIVE: Among current early screeners for psychosis-risk states, the Prodromal Questionnaire-16 items (PQ-16) is often used. We aimed to assess validity and reliability of the Italian version of the PQ-16 in a young adult help-seeking population. METHODS: We included 154 individuals aged 18-35years seeking help at the Reggio Emilia outpatient mental health services in a large semirural catchment area (550.000 inhabitants). Participants completed the Italian version of the PQ-16 (iPQ-16) and were subsequently evaluated with the Comprehensive Assessment of At-Risk Mental States (CAARMS). We examined diagnostic accuracy (i.e. specificity, sensitivity, negative and positive likelihood ratios, and negative and positive predictive values) and content, convergent, and concurrent validity between PQ-16 and CAARMS using Cronbach's alpha, Spearman's rho, and Cohen's kappa, respectively. We also tested the validity of the adopted PQ-16 cut-offs through Receiver Operating Characteristic (ROC) curves plotted against CAARMS diagnoses and the 1-year predictive validity of the PQ-16. RESULTS: The iPQ-16 showed high internal consistency and acceptable diagnostic accuracy and concurrent validity. ROC analyses pointed to a cut-off score of ≥5 as best cut-off. After 12months of follow-up, 8.7% of participants with a PQ-16 symptom total score of ≥5 who were below the CAARMS psychosis threshold at the baseline, developed a psychotic disorder. CONCLUSIONS: Psychometric properties of the iPQ-16 were satisfactory.