J Korean Neuropsychiatr Assoc.  2013 Nov;52(6):417-430.

The Development of Questionnaire for Relapse Assessment in Psychotic Disorder

Affiliations
  • 1Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. cykim@amc.seoul.kr

Abstract


OBJECTIVES
The aims of this study were to develop an instrument for detection of relapse in psychotic disorder and to validate the instrument.
METHODS
A total of 55 outpatients with psychotic disorder (schizophrenia, schizoaffective disorder, bipolar disorder) and 46 of their caregivers were enrolled. We developed the Questionnaire for Relapse Assessment in Psychotic disorder (QRAP), a self/report inventory. The patients and caregivers drew up the QRAP at two different time points, 'current' and 'the best state during the past three months'. In addition, we rated other established scales in order to evaluate psychotic and mood symptoms of patients. We divided patients into two groups, stable (n=30) and impending relapse (n=35) and evaluated the effectiveness of QRAP by calculating sensitivity and specificity.
RESULTS
For all patients and caregivers, QRAP total score at 'current' was higher than 'the best state during the past three months' and showed significant positive correlation with other established scales. As expected, QRAP total score at 'current' in the impending relapse group was higher than that of the stable group. With cut off criteria 1, the QRAP demonstrated 80.0% sensitivity and 56.3% specificity in caregivers and effectively detected impending relapse.
CONCLUSION
The results of our study suggest the effectiveness of QRAP as an instrument for detection of relapse in patients with psychotic disorder.

Keyword

Psychotic disorder; Relapse assessment; Screening test

MeSH Terms

Caregivers
Humans
Outpatients
Psychotic Disorders*
Surveys and Questionnaires*
Recurrence*
Sensitivity and Specificity
Weights and Measures

Figure

  • Fig. 1 Changes in Questionnaire for Relapse Assessment in Psychotic disorder (QRAP) total scores between stable group and impending relapse group [(A) by patients and (B) by caregivers]. Baseline means the best state during past 3 months.


Reference

1. Lieberman JA, Koreen AR, Chakos M, Sheitman B, Woerner M, Alvir JM, et al. Factors influencing treatment response and outcome of first-episode schizophrenia: implications for understanding the pathophysiology of schizophrenia. J Clin Psychiatry. 1996; 57:Suppl 9. 5–9.
2. Wiersma D, Nienhuis FJ, Slooff CJ, Giel R. Natural course of schizophrenic disorders: a 15-year followup of a Dutch incidence cohort. Schizophr Bull. 1998; 24:75–85.
Article
3. Shepherd M, Watt D, Falloon I, Smeeton N. The natural history of schizophrenia: a five-year follow-up study of outcome and prediction in a representative sample of schizophrenics. Psychol Med Monogr Suppl. 1989; 15:1–46.
Article
4. Salokangas RK, McGlashan TH. Early detection and intervention of psychosis. A review. Nord J Psychiatry. 2008; 62:92–105.
Article
5. Robinson DG, Woerner MG, Delman HM, Kane JM. Pharmacological treatments for first-episode schizophrenia. Schizophr Bull. 2005; 31:705–722.
Article
6. Perlis RH, Welge JA, Vornik LA, Hirschfeld RM, Keck PE Jr. Atypical antipsychotics in the treatment of mania: a meta-analysis of randomized, placebo-controlled trials. J Clin Psychiatry. 2006; 67:509–516.
7. Gilbert PL, Harris MJ, McAdams LA, Jeste DV. Neuroleptic withdrawal in schizophrenic patients. A review of the literature. Arch Gen Psychiatry. 1995; 52:173–188.
8. Hogarty GE, Ulrich RF. The limitations of antipsychotic medication on schizophrenia relapse and adjustment and the contributions of psychosocial treatment. J Psychiatr Res. 1998; 32:243–250.
Article
9. Thieda P, Beard S, Richter A, Kane J. An economic review of compliance with medication therapy in the treatment of schizophrenia. Psychiatr Serv. 2003; 54:508–516.
Article
10. Weiden PJ, Olfson M. Cost of relapse in schizophrenia. Schizophr Bull. 1995; 21:419–429.
Article
11. Penn DL, Waldheter EJ, Perkins DO, Mueser KT, Lieberman JA. Psychosocial treatment for first-episode psychosis: a research update. Am J Psychiatry. 2005; 162:2220–2232.
Article
12. Craig TK, Garety P, Power P, Rahaman N, Colbert S, Fornells-Ambrojo M, et al. The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis. BMJ. 2004; 329:1067.
Article
13. Crespo-Facorro B, Pérez-Iglesias R, Mata I, Caseiro O, Martínez-Garcia O, Pardo G, et al. Relapse prevention and remission attainment in first-episode non-affective psychosis. A randomized, controlled 1-year follow-up comparison of haloperidol, risperidone and olanzapine. J Psychiatr Res. 2011; 45:763–769.
Article
14. Petersen L, Nordentoft M, Jeppesen P, Ohlenschaeger J, Thorup A, Christensen TØ, et al. Improving 1-year outcome in first-episode psychosis: OPUS trial. Br J Psychiatry Suppl. 2005; 48:s98–s103.
15. Birchwood M, Smith J, Macmillan F, Hogg B, Prasad R, Harvey C, et al. Predicting relapse in schizophrenia: the development and implementation of an early signs monitoring system using patients and families as observers, a preliminary investigation. Psychol Med. 1989; 19:649–656.
Article
16. Jørgensen P. Schizophrenic delusions: the detection of warning signals. Schizophr Res. 1998; 32:17–22.
Article
17. Spaniel F, Vohlídka P, Hrdlicka J, Kozený J, Novák T, Motlová L, et al. ITAREPS: information technology aided relapse prevention programme in schizophrenia. Schizophr Res. 2008; 98:312–317.
Article
18. Salvatore P, Baldessarini RJ, Tohen M, Khalsa HM, Sanchez-Toledo JP, Zarate CA Jr, et al. McLean-Harvard International First-Episode Project: two-year stability of DSM-IV diagnoses in 500 first-episode psychotic disorder patients. J Clin Psychiatry. 2009; 70:458–466.
19. Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987; 13:261–276.
Article
20. Jung MH, Jang JH, Kang DH, Choi JS, Shin NY, Kim HS, et al. The reliability and validity of the Korean version of the structured interview for prodromal syndrome. Psychiatry Investig. 2010; 7:257–263.
Article
21. Hamilton M. Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol. 1967; 6:278–296.
Article
22. Yi JS, Bae SO, Ahn YM, Park DB, Noh KS, Shin HK, et al. Validity and reliability of the Korean version of the Hamilton Depression Rating Scale (K-HDRS). J Korean Neuropsychiatr Assoc. 2005; 44:456–465.
23. Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978; 133:429–435.
Article
24. Jung HY, Cho HS, Joo YH, Shin HK, Yi JS, Hwang S, et al. A validation study of the Korean-version of the Young Mania Rating Scale. J Korean Neuropsychiatr Assoc. 2003; 42:263–269.
25. Spearing MK, Post RM, Leverich GS, Brandt D, Nolen W. Modification of the Clinical Global Impressions (CGI) Scale for use in bipolar illness (BP): the CGI-BP. Psychiatry Res. 1997; 73:159–171.
Article
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