Long-term validity of the At Risk Mental State (ARMS) for predicting psychotic and non-psychotic mental disorders

TY - JOUR

T1 - Long-term validity of the At Risk Mental State (ARMS) for predicting psychotic and non-psychotic mental disorders

AU - Fusar-Poli, Paolo

AU - Rutigliano, Grazia

AU - Stahl, Daniel Richard

AU - Davies, Cathy

AU - De Micheli, Andrea

AU - Ramella-Cravaro , V

AU - Bonoldi, Ilaria

AU - McGuire, Philip

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Background The long-term clinical validity of the At Risk Mental State (ARMS) for the prediction of non-psychotic mental disorders is unknown. Methods Clinical register-based cohort study including all non-psychotic individuals assessed by the Outreach And Support in South London (OASIS) service (2002–2015). The primary outcome was risk of developing any mental disorder (psychotic or non-psychotic). Analyses included Cox proportional hazard models, Kaplan–Meier survival/failure function and C statistics. Results A total of 710 subjects were included. A total of 411 subjects were at risk (ARMS+) and 299 not at risk (ARMS−). Relative to ARMS−, the ARMS+ was associated with an increased risk (HR = 4.825) of developing psychotic disorders, and a reduced risk (HR = 0.545) of developing non-psychotic disorders (mainly personality disorders). At 6-year, the ARMS designation retained high sensitivity (0.873) but only modest specificity (0.456) for the prediction of psychosis onset (AUC 0.68). The brief and limited intermittent psychotic symptoms (BLIPS) subgroup had a higher risk of developing psychosis, and a lower risk of developing non-psychotic disorders as compared to the attenuated psychotic symptoms (APS) subgroup (P 

AB - Background The long-term clinical validity of the At Risk Mental State (ARMS) for the prediction of non-psychotic mental disorders is unknown. Methods Clinical register-based cohort study including all non-psychotic individuals assessed by the Outreach And Support in South London (OASIS) service (2002–2015). The primary outcome was risk of developing any mental disorder (psychotic or non-psychotic). Analyses included Cox proportional hazard models, Kaplan–Meier survival/failure function and C statistics. Results A total of 710 subjects were included. A total of 411 subjects were at risk (ARMS+) and 299 not at risk (ARMS−). Relative to ARMS−, the ARMS+ was associated with an increased risk (HR = 4.825) of developing psychotic disorders, and a reduced risk (HR = 0.545) of developing non-psychotic disorders (mainly personality disorders). At 6-year, the ARMS designation retained high sensitivity (0.873) but only modest specificity (0.456) for the prediction of psychosis onset (AUC 0.68). The brief and limited intermittent psychotic symptoms (BLIPS) subgroup had a higher risk of developing psychosis, and a lower risk of developing non-psychotic disorders as compared to the attenuated psychotic symptoms (APS) subgroup (P 

UR - http://www.scopus.com/inward/record.url?scp=85012284827&partnerID=8YFLogxK

U2 - 10.1016/j.eurpsy.2016.11.010

DO - 10.1016/j.eurpsy.2016.11.010

M3 - Article

AN - SCOPUS:85012284827

SN - 0924-9338

VL - 42

SP - 49

EP - 54

JO - European Psychiatry

JF - European Psychiatry

ER -