Data Sheet 2_Detection of psychosis risk: reliability and validity of the Spanish version of the Comprehensive Assessment of At-Risk Mental States interview (CAARMS-S).pdf

IntroductionThe early identification of psychosis risk is critical, particularly within the first 2 years of the at-risk phase, as timely intervention may reduce the likelihood of transitioning to psychosis. This study evaluates the reliability and validity of the Spanish version of the Comprehensive Assessment of At-Risk Mental States (CAARMS-S) interview.
MethodsA prospective longitudinal study was conducted with 36 individuals at ultra-high risk (UHR), 43 with First-Episode Psychosis (FEP), and 14 matched controls, all of whom were part of the Early Intervention Program in Catalonia. Data collection involved clinical interviews and multiple validated scales, including the CAARMS-S, the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF), the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II), and the Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS-PL).
ResultsReliability testing showed excellent internal consistency (Cronbach’s α = 0.93) and inter-observer reliability [intraclass correlation coefficient (ICC) = 0.92]. Construct validity was supported by significant differences in PANSS positive subscale scores among UHR, FEP, and control groups (p < 0.001). Strong correlations were observed between CAARMS-S and PANSS subscales (positive: r = 0.608; negative: r = 0.495; general: r = 0.577). After 6 months, only one UHR participant (3.3%) transitioned to psychosis. Both CAARMS-S and PANSS were sensitive to changes in positive symptoms, with CAARMS-S being more responsive to negative symptoms and PANSS to general psychopathology.
DiscussionThese findings confirm that CAARMS-S is a reliable, valid, and sensitive tool for identifying and monitoring individuals at risk of psychosis in Spanish-speaking clinical settings, supporting its use in early intervention programs.

引言
精神病风险的早期识别至关重要，尤其在高危阶段的前2年内，及时干预可降低个体转化为精神病的概率。本研究旨在评估西班牙语版高危精神状态综合评估访谈（Comprehensive Assessment of At-Risk Mental States, CAARMS-S）的信度与效度。

方法
本研究针对加泰罗尼亚早期干预项目中的受试者开展前瞻性纵向研究，共纳入36名超高危（ultra-high risk, UHR）个体、43名首发精神病（First-Episode Psychosis, FEP）患者及14名匹配对照者。数据收集采用临床访谈与多种经过验证的量表，包括CAARMS-S、阳性与阴性症状量表（Positive and Negative Syndrome Scale, PANSS）、整体功能评定量表（Global Assessment of Functioning, GAF）、DSM-IV轴II人格障碍结构化临床访谈（Structured Clinical Interview for DSM-IV Axis II Personality Disorders, SCID-II）以及儿童情感障碍与精神分裂症诊断量表（Kiddie-Schedule for Affective Disorders and Schizophrenia, K-SADS-PL）。

结果
信度检验结果显示，该量表具有极佳的内部一致性（克朗巴赫α系数=0.93）与评定者间信度（组内相关系数（intraclass correlation coefficient, ICC）=0.92）。结构效度方面，超高危组、首发精神病组与对照组在PANSS阳性症状分量表得分上存在显著差异（p<0.001）。CAARMS-S与PANSS各分量表间均存在较强相关性：阳性症状分量表r=0.608，阴性症状分量表r=0.495，一般精神病理分量表r=0.577。随访6个月后，仅1名超高危受试者（3.3%）转化为精神病。CAARMS-S与PANSS均对阳性症状的变化具有敏感性，其中CAARMS-S对阴性症状的响应性更佳，而PANSS则对一般精神病理症状更为敏感。

讨论
上述研究结果证实，CAARMS-S是一款可靠、有效且敏感的工具，可用于西班牙语区临床场景中精神病高危个体的识别与监测，支持其在早期干预项目中的应用。