Using online screening in the general population to detect participants at clinical high-risk for psychosis

Mhairi McDonald, Eleni Christoforidou, Nicola Van Rijsbergen, Ruchika Gajwani, Joachim Gross, Andrew I. Gumley, Stephen M. Lawrie, Matthias Schwannauer, Frauke Schultze-Lutter, Peter J. Uhlhaas*

*Corresponding author for this work

Research output: Contribution to journalArticle (journal)peer-review

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Introduction: Identification of participants at clinical high-risk (CHR) for the development of psychosis is an important objective of current preventive efforts in mental health research. However, the utility of using web-based screening approaches to detect CHR participants at the population level has not been investigated. Methods: We tested a web-based screening approach to identify CHR individuals. Potential participants were invited to a website via e-mail invitations, flyers, and invitation letters involving both the general population and mental health services. Two thousand two hundred seventy-nine participants completed the 16-item version of the prodromal questionnaire (PQ-16) and a 9-item questionnaire of perceptual and cognitive aberrations (PCA) for the assessment of basic symptoms (BS) online. 52.3% of participants met a priori cut-off criteria for the PQ and 73.6% for PCA items online. One thousand seven hundred eighty-seven participants were invited for a clinical interview and n = 356 interviews were conducted (response rate: 19.9%) using the Comprehensive Assessment of At-Risk Mental State (CAARMS) and the Schizophrenia Proneness Interview, Adult Version (SPI-A). n = 101 CHR participants and n = 8 first-episode psychosis (FEP) were detected. ROC curve analysis revealed good to moderate sensitivity and specificity for predicting CHR status based on online results for both UHR and BS criteria (sensitivity/specificity: PQ-16 = 82%/46%; PCA = 94%/12%). Selection of a subset of 10 items from both PQ-16 and PCA lead to an improved of specificity of 57% while only marginally affecting sensitivity (81%). CHR participants were characterized by similar levels of functioning and neurocognitive deficits as clinically identified CHR groups. Conclusion: These data provide evidence for the possibility to identify CHR participants through population-based web screening. This could be an important strategy for early intervention and diagnosis of psychotic disorders.

Original languageEnglish
Pages (from-to)600-609
Number of pages10
JournalSchizophrenia Bulletin
Issue number3
Early online date8 Jun 2018
Publication statusPublished - 13 May 2019


  • Basic symptoms
  • Clinical high-risk
  • Early intervention
  • Psychosis
  • Web screening


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