Secondary prevention of schizophrenia: utility of standardized scholastic tests in early identification

Beng-Choon Ho; Nancy C Andreasen; Peg Nopoulos; Rebecca Fuller; Stephan Arndt; Remi J Cadoret

doi:10.1080/10401230590905272

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Secondary prevention of schizophrenia: utility of standardized scholastic tests in early identification

Journal article

Peer reviewed

Secondary prevention of schizophrenia: utility of standardized scholastic tests in early identification

Beng-Choon Ho, Nancy C Andreasen, Peg Nopoulos, Rebecca Fuller, Stephan Arndt and Remi J Cadoret

Annals of clinical psychiatry, Vol.17(1), pp.11-18

01/2005

DOI: 10.1080/10401230590905272

PMID: 15942998

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Abstract

Given the enormous societal burden of schizophrenia, there has been a growing interest in its prevention during the past decade. Early detection and prompt treatment may improve outcome in schizophrenia. In this study, we examine the value of using pre-morbid cognitive impairment in early detection. Standardized achievement tests Iowa Test of Basic Skills (ITBS) and Iowa Tests of Educational Development (ITED) at Grades 4, 8 and 11 were examined in 70 patients with schizophrenia and 147 comparison subjects without schizophrenia. The majority of comparison subjects later developed another major mental illness such as substance abuse or mood disorder. Receiver operating characteristic curves were used to test the efficiency and accuracy of pre-morbid cognitive tests for differentiating adolescents who will later develop schizophrenia from those who remain well or develop another mental illness. Although schizophrenia patients had lower mean percentile ranks than comparison subjects in every ITBS/ITED sub-test, these differences were only associated with small increases in risk for schizophrenia. Standardized scholastic tests achieved moderate sensitivity and specificity, and enhanced the detection of schizophrenia by three to five fold. However, positive predictive values were low. ITBS/ITED scores alone cannot be used in screening the general population, given the low positive predictive values. Combining ITBS/ITED scores with other risk factors, such as family history, may lead to more efficient early detection. Our findings illustrate the challenges facing the secondary prevention of schizophrenia. Priority should be given to developing efficient and accurate methods of early detection in order to reduce the dangers of making erroneous false positive diagnoses, and to decrease exposure to unnecessary treatment during the testing of early interventions.

Predictive Value of Tests

Reproducibility of Results

Intelligence Tests - statistics & numerical data

Humans

Risk Factors

Male

Psychometrics

Schizophrenic Psychology

Cognition Disorders - diagnosis

Educational Measurement - methods

Schizophrenia - diagnosis

Schizophrenia - prevention & control

Sensitivity and Specificity

Sex Factors

Adult

Female

Achievement

Longitudinal Studies

Cognition Disorders - psychology

Educational Measurement - statistics & numerical data

Details

Title: Subtitle: Secondary prevention of schizophrenia: utility of standardized scholastic tests in early identification
Creators: Beng-Choon Ho - Department of Psychiatry, University of Iowa College of Medicine, Iowa City, IA 52242, USA. beng-ho@uiowa.edu
Nancy C Andreasen
Peg Nopoulos
Rebecca Fuller
Stephan Arndt
Remi J Cadoret
Resource Type: Journal article
Publication Details: Annals of clinical psychiatry, Vol.17(1), pp.11-18
DOI: 10.1080/10401230590905272
PMID: 15942998
NLM abbreviation: Ann Clin Psychiatry
ISSN: 1040-1237
eISSN: 1547-3325
Publisher: United States
Grant note: MH31593 / NIMH NIH HHS MHCRC 43271 / NIMH NIH HHS
Language: English
Date published: 01/2005
Academic Unit: Neurology; Psychiatry; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Biostatistics; Nursing; Injury Prevention Research Center
Record Identifier: 9984003960002771

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