Identification of Young People at Risk of Psychosis: Validation of Personal Assessment and Crisis Evaluation Clinic Intake Criteria

Abstract

Objective To describe the development and validation of the criteria used at the Personal Assessment and Crisis Evaluation (PACE) Clinic to identify young people at ‘ultra-high’ risk of developing a psychotic disorder within a short follow-up period. Method The PACE Clinic criteria initially grew out of clinical observations and retrospective research describing the prodromal phase of first-episode psychosis. Early prospective research refined the criteria into the three intake groups for the Clinic. These criteria combine putative state and trait risk factors for psychosis. Whether or not a person meets criteria for one or more of these groups can usually be determined by a thorough psychological assessment interview. Two early studies are described that assess the validity of this screening protocol. Results The transition rate to acute psychosis of the ‘ultra-high’ risk group identified in the second study was 41%. Conclusions These results suggest that it is possible to accurately identify young people at imminent risk of psychosis. The PACE criteria have now been adopted (or adapted) by a number of other clinical research programs both in Australia (i.e. Psychological Assistance Service in Newcastle) and other programs in the United States and elsewhere. This research may lead the way to the development of preventive interventions for the ultra-high risk group.