ABSTRACT
This study aimed to assess the psychometric properties of the Chinese version of the Revised Clinical Interview Schedule (C-CIS-R), and explore its applicability as a diagnostic instrument for common mental disorders (CMDs) in Hong Kong. Its psychometric properties were evaluated among 140 patients and 161 healthy controls. In comparison to the diagnoses made by the Structured Clinical Interview for the DSM-IV, the C-CIS-R showed good criterion validity in diagnosing CMDs. The correlation of the total score of C-CIS-R with the 12-item General Health Questionnaire and Hospital Anxiety and Depression Scale was satisfactory, indicating favourable convergent validity as well. The inter-rater and test-retest reliability were also satisfactory. Receiver operating characteristic analyses suggested an optimal cut-off point of 11/12 for detecting diagnosable CMDs (sensitivity: 0.69; specificity: 0.93) and 17/18 for identifying a need for treatment (sensitivity: 0.70; specificity: 0.95). In conclusion, C-CIS-R is a valid diagnostic instrument for CMDs in a Chinese community. Its cut-off points for clinically significant symptoms and treatment needs among Chinese are identical to those adopted in the original English version.
Subject(s)
Asian People/psychology , Mental Disorders/diagnosis , Psychiatric Status Rating Scales/standards , Adolescent , Adult , Aged , Case-Control Studies , Diagnostic and Statistical Manual of Mental Disorders , Female , Hong Kong , Humans , Male , Middle Aged , Psychometrics , Young AdultABSTRACT
This review examines the clinical and theoretical evidence justifying early intervention in individuals with schizophrenia. Potential reasons for the previous lack of emphasis on early intervention are discussed. Interventions that target psychosis are distinguished from those that work on prodromal symptoms. It is suggested that early intervention programmes should try to reduce the duration of untreated psychosis. The relationship between this and outcome is discussed. Improving service accessibility alone may not be sufficient, and education and destigmatisation input may be required. Once a patient is identified, vigorous pharmacological and psychosocial interventions are important to improve the long-term clinical outcome. An effective early intervention programme for psychosis provides a basis for the future development of a prodrome intervention programme.
