scale of prodromal symptoms pdf

Usually not getting to scheduled activities at all.Unable to sleep at all for over 48 hours.Rating based on: Symptom Onset (for symptoms rated at a level 3 or higher)Record date when the earliest symptom first occurred: ( Entire lifetime or “ever since I can remember” ( Cannot be determined ( Date of onset ________________/_______ Month Year G.2 DYSPHORIC MOOD INQUIRY: 1. DESCRIPTION: UNUSUAL THOUGHT CONTENT/DELUSIONAL IDEAS Perplexity and delusional mood. Anxiety, stress, the feeling of being left out, being uncertain about the choices to be made in daily situations, and facing troubles sustaining attention and concentration, are some of the characteristic symptoms. The Global Assessment of Functioning Scale showed that functioning is differentially affected among the subtypes even in the prodromal phase. Do you ever feel that you have to pay close attention to what's going on around you in order to feel safe? Somatic Ideas: Do you ever worry that something might be wrong with your body or your health? Unusual perceptual experiences. GRANDIOSE IDEAS INQUIRY: 1. N NI Y (Record Qualifiers) 2. Motor Disturbances (p. 33) 0 1 2 3 4 5 6 G4. Third party reports alone do not qualify. Do you think this is real? Current psychosis is defined by the presence of Positive Symptoms. The Scale of Prodromal Symptoms (SOPS) was developed to identify individuals experiencing early signs of psychosis, a critical first step towards early intervention. They are rated on the SOPS P2 Scale at the end of the queries. P. 4. N NI Y (Record Qualifiers) 3. 5 . Unrealistic goals that may affect plans and functioning, but responsive to other’s concerns and limits.Compelling beliefs of superior intellect, attractiveness, power, or fame. Do you have any hobbies, special interests or collections? Stereotyped verbal content. a. Anxiety, panic, multiple fears and phobias. D. 4. To meet criteria for an attenuated symptom, a patient must receive a rating of level “3”, “4”, or “5” on scales P1-P5 of the SOPS. Social Anhedonia (p. 21) 0 1 2 3 4 5 6 N2. N NI Y (Record Response) Do people more and more use words you don’t understand? IMPAIRMENT IN PERSONAL HYGIENE INQUIRY: 1. (Does it bother you?) Any queries (other than missing content) should be directed to the corresponding author for the article. Not a part of the living world? None Mild Moderate Severe 1. No bathing and has developed an odor. Rating based on: Symptom Onset (for symptoms rated at a level 3 or higher)Record date when the earliest symptom first occurred: ( Entire lifetime or “ever since I can remember” ( Cannot be determined ( Date of onset ________________/_______ Month Year D. 4. Are you finding that you are feeling challenged or overwhelmed by some of your daily activities? Misses or interprets many similarities and proverbs concretely.Able to follow and answer simple statements and questions, but has difficulty independently articulating thoughts and experiences. DESCRIPTION: OCCUPATIONAL FUNCTIONING a. Avolition (p. 22) 0 1 2 3 4 5 6 N3. A score of “1” to “5” on one or more of scales P1-P5 indicates a Positive Symptoms that is at a non-psychotic level intensity. frequent fights with family and/or neglects family or has no home) Serious impairment in judgment (including inability to make decisions, confusion, disorientation) Serious impairment in thinking (including constant preoccupation with thoughts, distorted body image, paranoia) Serious impairment in mood (including constant depressed mood plus helplessness and hopelessness, or agitation, or manic mood) Serious impairment due to anxiety (panic attacks, overwhelming anxiety) Other symptoms: some hallucinations, delusions, or severe obsessional rituals Passive suicidal ideation A person with 1 area of disturbance = rating 48-50 A person with 2 areas of disturbance = rating 44-47 A person with 3 areas of disturbance = rating 41-43 A person with 4 areas of disturbance = rating 38-40 A person with 5 areas of disturbance = rating 34-37 A person with 6 areas of disturbance = rating 31-33 INABILITY TO FUNCTION IN ALMOST ALL AREAS: 30 - 21Suicidal preoccupation or frank suicidal ideation with preparation OR behavior considerably influenced by delusions or hallucinations OR serious impairment in communication (sometimes incoherent, acts grossly inappropriately, or profound stuporous depression) Serious impairment with work, school, or housework if a housewife/househusband (e.g. Do you ever feel that it could just be in your head? 3. They occur at the early stages of various brain diseases, too. N NI Y (Record Qualifiers) 3. c. Motor blockages (catatonia). Page 4 Family History of Mental Illness………………………………………. Baseline SOPS data were subjected to principal axis factoring (PAF), estimating factors based on shared variance, with Oblimin rotation. Moderately Severe 5. Overview (cont’d): Family History of Mental Illness 1. Who are your first-degree relatives (i.e. Preliminary dimension reduction analyses suggested that psychosis-risk symptoms may deviate from the traditional symptom structure of schizophrenia, but findings have been inconsistent. eventually getting to the point). Verbal content may be repetitious and perseverative. The first test is temporal sequence. Do you ever feel that you have been chosen by God for a special role? Anchors in each scale are intended to provide guidelines and examples of signs for every symptom observed. 2003;29(4):703-15. Do you ever feel as if your thoughts are being said out loud so that other people can hear them? Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. The changes that have been observed in the prodromal phase are very general and could be signs of many different things, including ordinary adolescent behaviour. INQUIRY Within each section of the SOPS, a series of questions are listed with space provided for recording responses (“N” = No; “NI”= No Information; “Y” = Yes). DESCRIPTION: ODD BEHAVIOR OR APPEARANCE a. Overvalued beliefs. N. 5. Brief Intermittent Psychotic Syndrome (BIPS) The Brief Intermittent Psychotic Syndrome is defined by frankly psychotic symptoms that are recent and very brief. It is not necessary to meet every criterion in any one anchor to assign a particular rating. Whilst cognitive patterns in pro-DLB have been described as different from prodromal AD (pro-AD) [3, 4], with patients with DLB at this early stage having more visuospatial and fluency deficits than Abstract. Does having the experience ever cause you to do anything differently? Have you had thoughts of harming yourself or ending your life? trouble getting up for school or work). Do you ever smell or taste things that other people don't notice? It is not necessary to meet every criterion in any one anchor to assign a particular rating. If you do not receive an email within 10 minutes, your email address may not be registered, Questions that are not printed in boldface are optional and can be included for clarification or elaboration of positive responses. How have things been going for you recently? It is not necessary to meet every criterion in any one anchor to assign a particular rating. Record Response 5. N NI Y (Record Qualifiers) QUALIFIERS: For all “Y” responses, record: ( Description-Onset-Duration-Frequency ( Degree of Distress: What is this experience like for you? Delusions may be present but are not well organized and not tenaciously held. Receiving notice or being on probation at work. The familiar feels strange, confusing, ominous, threatening, or has special meaning. N g { è Prefers to be alone. Does having the experience ever cause you to do anything differently? May feel disconnected from body, from world, from time. N NI Y (Record Qualifiers) 3. Anchors in each scale are intended to provide guidelines and examples of signs for every symptom observed. What is it? Do other people tell you that your ideas or beliefs are unusual or bizarre? III. PAF yielded four latent factors explaining 36.1% of total variance: positive symptoms; distress; negative symptoms; and deteriorated thought process. INTRODUCTION: We conduct an exploratory factor analysis with the Scale of Prodromal Symptoms (SOPS) items, to determine its psychometric characteristics and construct validity, as well as we analyze criterion or predictive validity of its clinical subscales in the conversion of high mental risk subjects from prodrome to psychosis in a 1 year follow-up period. More difficulty habituating. N NI Y (Record Response) For all responses, record: description, onset, duration, and change over time. This study investigated the phenomenology of psychosis risk symptoms in a large sample from a multi‐site, national study using rigorous factor analysis procedure. ( Degree of Conviction/Meaning: How do you account for this experience? d. Loss of automatic skills. Passively goes along with social activitiesFew friends outside of extended family. Basis for ratings includes both interviewer observations and patient reports. This study examines the ability of the Scale of Prodromal Symptoms (SOPS) to differentiate between negative and depression symptoms in a young help-seeking ultrahigh risk (UHR) group. Interferes persistently with thinking, feeling, social relations and/or behavior. Have you felt that things happening around you have a special meaning for just you? These experiences are rated on the SOPS P1 Scale at the end of the queries. N NI Y (Record Qualifiers) QUALIFIERS: For all “Y” responses, record: ( Description-Onset-Duration-Frequency ( Degree of Distress: What is this experience like for you? The symptoms of the psychosis prodrome and the symptoms of SPD are similar on a cross-sectional basis. (Y/N) 2. The severity of the prodromal state is judged according to the sum of the ratings from each of the SOPS items and ranges from 0 to 114. Rate the current severity of the psychosis-risk symptoms Patients meeting criteria for one or more psychosis-risk syndromes are further evaluated using the SOPS rating scales for Negative Symptoms, Disorganizing Symptoms, and General Symptoms. Do people ever tell you that your plans or goals are unrealistic? Never? P. 5. Non-persecutory ideas of reference. 3. Suspiciousness/Persecutory Ideas (p. 13) 0 1 2 3 4 5 6 P3. For those first-degree relatives who have a history of mental illness: Name of relativeName of problemSymptomsDurationTreatment history 3. N NI Y (Record Response) 3. It therefore might be useful for the prediction of the disorder, especially if it is further refined to select those items with particularly high prognostic accuracy. Learn about our remote access options, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA, Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA, Imaging Research Center, University of California Davis, Sacramento, California, USA, Department of Psychiatry, Stanford University, Palo Alto, California, USA, Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore‐Long Island Jewish Health System, Glen Oaks, New York, USA, Center for Neuroscience, University of California Davis, Sacramento, California, USA, Mid‐Valley Behavioral Care Network, Marion County Health Department, Salem, Oregon, USA, Maine Medical Center Research Institute, Tufts University Medical School, Portland, Maine, USA. Sense that people may wish harm. Each question that elicits a positive (i.e. Are you failing any classes or considering dropping out of school? N NI Y (Record Response) For all responses, record: description, onset, duration, and change over time. Record Response 3. Conclusions:The Bonn Scale for the Assessment of Ba-sic Symptoms operationalization of prodromal symp-toms performed well in the early detection of schizo-phrenia. Page 31 D.4 Impairment in Personal Hygiene…………………………..……………………….. This article provides further data on these psychometric parameters for the prodromal assessment instruments developed by the Prevention through Risk Identification, Management, and Education (PRIME) prodromal research team at Yale University: the Structured Interview for Prodromal Syndromes and the Scale of Prodromal Symptoms. Problematic absence from work. Positive Symptoms are rated on scales P1-P5 of the Scale of Psychosis-risk Symptoms (SOPS). N NI Y (Record Response) Sometimes? If a Positive Symptom also satisfies the (B) criterion, a current psychosis is defined. Emotions disappearing, difficulty feeling happy or sad. Can be redirected with occasional questions and structuring.Speech tangential (i.e. Some prodromal centers recommend against long-term antipsychotics unless and until an established DSM-IV diagnosis of psychosis can be made 20 or until frank positive symptoms have emerged for at least 1 week. Reported or observed clumsiness, lack of coordination, difficulty performing activities that were performed without problems in the past. It is not necessary to meet every criterion in any one anchor to assign a particular rating. Emotional experiences and feelings less recognizable and genuine, appropriate. Do you ever think you see people, animals, or things, but then realize they N NI Y (Record Qualifiers) may not really be there? Is this getting worse than it was before? This study describes (1) the prevalence and association of PS with patients’ baseline ACS-related acute symptoms of pain intensity and state anxiety and (2) the relationship of PS to co-morbidity. Rating based on: Symptom Onset (for symptoms rated at a level 3 or higher)Record date when the earliest symptom first occurred: ( Entire lifetime or “ever since I can remember” ( Cannot be determined ( Date of onset ________________/_______ Month Year D. DISORGANIZATION SYMPTOMS D. 1. Do you find yourself feeling irritable a lot of the time? Do people ever tell you that they can't understand you? SOMATIC DISTORTIONS, ILLUSIONS, HALLUCINATIONS INQUIRY: 1. N NI Y (Record Qualifiers) 2. In medicine, a prodrome is an early sign or symptom (or set of signs and symptoms) that often indicates the onset of a disease before more diagnostically specific signs and symptoms develop. The overview should include: Any behaviors and symptoms obtained from the phone screen or prescreen (if applicable). Followup data of 6 months or more were available on 34 of these subjects; 9 of these (26.5%) developed psychotic disorders. mild or lessened depression and/or mild insomnia) Some persistent difficulty in social, occupational, or school functioning (e.g. Learn more. May affect functioning.Experiences familiar, anticipated. Do you ever feel a loss of sense of self or feel disconnected from yourself or your life? c. Presents a guarded or even openly distrustful attitude that may reflect delusional conviction and intrude on the interview and/or behavior. Would you be more social if you had the opportunity? C h e c k o n e : ( L i k e l y ( N o t l i k e l y P . Sleeping problems. d. Day night reversal. All boldface inquiries should be asked. Up until that point, even professionals can only have a hunch that the changes may be the start of psychosis. Diminished conversa-tional give and take.Correctly interprets most similarities and proverbs. Preoccupying, distressing. Have you ever attempted suicide? hùSÕ CJ hùSÕ >*CJ hùSÕ 5�CJ hùSÕ >*hùSÕ hùSÕ 5�h]H hùSÕ 5�mHsHh]H hùSÕ ;�>*mHsH ä å # $ F G r º ø ù / 0 õ ö = > m – ú í ë é ä ä é Ú Ú Ø Ø Ø Ø Ö Ø Ì Ì Æ Ø » µ „Ğ`„Ğ Do you think this is real? Ƹ dğ ¤ $ a$ $ „À„°^„À`„°a$ $a$ – µ ¶ k r ¤ « × Ø ' ½ À õ ö ÷ ù ù ô â Ó Á Ó ± « ¡ � Ó Š ˆ ˆ Heightened or dulled perceptions, vivid sensory experiences, distortions, illusions. Spends most time alone or with first-degree relatives.No friends. Page 7 P.2 Suspiciousness/Persecutory Ideas………………………..………………………….. Grandiosity (p. 15) 0 1 2 3 4 5 6 P4. BIZARRE THINKING INQUIRY: Do people ever say your ideas are unusual or that the way you think is strange or illogical? Alien? How often do you shower? Productivity is considered average or is within normal limits.Low levels of motivation to participate in goal-directed activities. Preliminary dimension reduction analyses suggested that psychosis‐risk symptoms may deviate from the traditional symptom structure of schizophrenia, but findings have been inconsistent. If the positive symptoms were present before onset of the co-occurring disorder or persist when the co-occurring diagnosis is in remission,, rate NOT better explained. Global assessment of functioning: A modified scale, Psychosomatics, 36, 267-275. Data from the Scale of Prodromal Symptoms (SOPS) [Early Intervention in Psychotic Disorders, pp. Unreal? Relative prominence of the factors and symptom frequency support early identification strategies focusing on positive symptoms and distress. Developmental history Social history and any recent changes Trauma history History of substance use Now I’d like to ask you some more general questions. 4 . N NI Y (Record Response) 2. Participants were 30 individuals between the ages of 13 and 25 who were identified as prodromal to psychosis using the Structured Interview for Prodromal Syndromes/Scale of Prodromal Symptoms (SIPS/SOPS; Miller et al., 2003). Each item has a severity scale rating from 0 (Never, Absent) to 6 (Severe/Extremeand Psychotic, for the positive items). Based on retrospective studies of both adults and children, sleep disturbances, anxiety, depressive symptoms, affective la- the study did not include criteria assessing prodromal symptoms or classifications. The Prodromal Questionnaire-Brief version (PQ-B) contains 21 items derived from the PQ. DESCRIPTION: EXPRESSION OF EMOTION a. An apple and a banana? b. Suspiciousness or paranoid thinking. When patients meet some criteria within one anchor and some criteria within an adjacent anchor such that a clear anchor cannot be chosen, rate to the extreme. cant prodromal period.56 It appears as if the nonspecific symptoms and negative symptoms usually develop first and then attenuated positive symptoms.2 Although most individuals with schizophrenia have experienced a prodromal period, it is less clear how many of those who experience prodromal symptoms will subsequently develop a psychotic illness. N NI Y (Record Response) 2. May have day/night reversal. Have sounds seemed different? A score of “6” on one or more of scales P1-P5 indicates that a Positive Symptom is at a “Severe and Psychotic” level of intensity and thus, the (A) criteria is met. Do you ever feel that it could just be in your head? The SOPS is used independently to determine the severity of the prodromal state once such a state has been diagnosed. N E G A T I V E S Y M P T O M S N . Ideas of reference (excluding delusions of reference) b. Thus, it is crucial to bettercharacterizethe prodromal symptoms preceding bipolar disorder onset. Do you ever feel that some person or force may be controlling or interfering with your thinking? Do you have a sense of who that might be? NOTE: Date when criteria first achieved (mm/dd/yy): ______________________________________ C. Genetic Risk and Deterioration Psychosis-Risk SyndromeYesNo1.The patient meets criteria for Schizotypal Personality Disorder.2. Have you ever found yourself feeling mistrustful or suspicious of other people? e. Difficulty concentrating. Magical thinking that influences behavior and is inconsistent with subculture norms (e.g. Confusing? Do your emotions feel less strong in general than they used to? items, and four General Symptom items. Are you aware of any ongoing difficulties getting your point across, such as finding yourself rambling or going off track when you talk? 2. Basis for ratings includes both interviewer observations and patient reports. Disconnec-tion of affect and speech. C h e c k o n e : ( L i k e l y ( N o t l i k e l y O v e r v i e w : T h e p u r p o s e o f t h e o v e r v i e w i s t o o b t a i n i n f o r m a t i o n a b o u t w h a t h a s brought the person to the interview, recent functioning, and educational, developmental, occupational, and social history. How often do you spend time with friends outside of school/work? Basis for ratings includes both interviewer observations and patient reports. Irritability (45%), insomnia (45%), and reduced energy (43.8%) were the most frequent prodromal symptoms. Having difficulty falling asleep. PATIENTS CAN MEET CRITERIA FOR ONE OR MORE SYNDROME TYPES. Use the Scale. frequent shoplifting, arrests) or occasional combative behavior Serious impairment in relationships with friends (e.g. PRESENCE OF PSYCHOTIC SYMPTOMS CRITERIA (POPS) Current psychosis is defined as follows: Both (A) and (B) are required. It is not necessary to meet every criterion in any one anchor to assign a particular rating. Does having the experience ever cause you to do anything differently? They occur at the early stages of various brain diseases, too. Participants were 334 help‐seeking youth (age: 17.0 ± 3.3) from the Early Detection and Intervention for the Prevention of Psychosis Program, consisting of 203 participants at clinically higher risk (sum of P scores ≥ 7), 87 with clinically lower risk (sum of P scores < 7) and 44 in very early first‐episode psychosis (<30 days of positive symptoms). Thus, it is crucial to bettercharacterizethe prodromal symptoms preceding bipolar disorder onset. Distracted and often loses track of conversations.Can maintain attention and remain in focus only with outside structure or support.Unable to maintain attention even with external refocusing. Anchors in each scale are intended to provide guidelines and examples of signs for every symptom observed. MOTOR DISTURBANCES General Symptom Scale 0 Absent1 Questionably Present2 Mild3 Moderate4 Moderately Severe5 Severe 6 ExtremeAwkward.Reported or observed clumsiness.Poor coordination. Basis for ratings includes both interviewer observations and patient reports. Affects daily functioning.Hallucinations perceived as real and distinct from the person's thoughts. N NI Y (Record Qualifiers) 4. Psychosis risk screening with the Prodromal Questionnaire — Brief Version (PQ-B) Rachel L. Loewya,⁎, Rahel Pearsona, Sophia Vinogradova,b, Carrie E. Beardenc,d, Tyrone D. Cannonc,d a Department of Psychiatry, University of California at San Francisco, San Francisco, CA, United States b San Francisco Department of Veteran's Affairs Medical Center, San Francisco, CA, United States There are two tests. N NI Y (Record Response) For all responses, record: description, onset, duration, and change over time ABSTRACTION QUESTIONS: Similarities – How are the following alike? Difficult to awaken for appointments. Not participating in virtually any goal-directed activities.Rating based on: Symptom Onset (for symptoms rated at a level 3 or higher)Record date when the earliest symptom first occurred: ( Entire lifetime or “ever since I can remember” ( Cannot be determined ( Date of onset ________________/_______ Month Year N. 3. Scale for the Assessment of BS (BSABS - 1962, 1987) thought, perception and motor BS and operationally defmed. There is no standard tool for measuring the symptoms of the bipolar prodrome, which has limited progress toward early identification. Do you feel as if you are unusually gifted in any particular area? Baseline attenuated positive symptoms were rated in 42 putatively prodromal patients in the RAP program using the Scale of Prodromal Symptoms (SOPS). OCCUPATIONAL FUNCTIONING INQUIRY: 1. N NI Y (Record Response) 2. Do you think this is real? (Record Response) 3. Anchors in each scale are intended to provide guidelines and examples of signs for every symptom observed. Dysphoric Mood (p. 32) 0 1 2 3 4 5 6 G3. c. Daytime fatigue and sleeping during the day. IMPAIRED TOLERANCE TO NORMAL STRESS INQUIRY: 1. The Scale of Prodromal Symptoms (SOPS) was developed to identify individuals experiencing early signs of psychosis, a critical first step towards early intervention. To meet criteria for BIPS, a psychotic intensity symptom (SOPS score = 6) must have begun in the past three months and must be present at least several minutes a day at a frequency of at least once per month. Poor rapport. Feeling depersonalized, unreal or strange. May have developed an odor. 1 . Vague, metaphorical overelaborate, stereotyped. b. Irritability, hostility, rage. Motor blockages. C h e c k o n e : ( L i k e l y ( N o t l i k e l y P . N NI Y (Record Qualifiers) 6. SOPS data of 77 help-seeking patients at UHR for psychosis were analyzed with an exploratory factor analysis. A painting and a poem? __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ P.2 DESCRIPTION: SUSPICIOUSNESS/PERSECUTORY IDEAS a. Persecutory ideas of reference. Note: Date when criteria first achieved (mm/dd/yy): ____________________________________ Rule in psychosis-risk syndrome: CRITERIA OF PSYCHOSIS-RISK SYNDROMES (COPS 3.0) A. Are you superstitious? DESCRIPTION: SOCIAL ANHEDONIA a. Listening? (Does it bother you?) few friends or conflicts with co-workers) A person with EITHER moderate symptoms OR moderate difficulty in social, work, or school functioning = rating 58-60 A person with moderate difficulty in more than 1 area of social, work, or school functioning = rating 54-57 A person with BOTH moderate symptoms AND moderate difficulty in social, work, and school functioning = rating 51-53 Global Assessment of Functioning (cont’d) SOME SERIOUS SYMPTOMS OR IMPAIRMENT IN FUNCTIONING: 50 - 31Serious impairment with work, school, or housework if a housewife/househusband (e.g. EXPERIENCE OF EMOTIONS AND SELF Negative Symptom Scale 0 Absent1 Questionably Present2 Mild3 Moderate4 Moderately Severe5 Severe 6 ExtremeFeeling distant from others. Do you know what it means to be superstitious? The Scale of Prodromal Symptoms (SOPS) was developed to identify individuals experiencing early signs of psychosis, a critical first step towards early intervention. Most psychotic episodes will be preceded by a prodromal period, however the nature and … Anchors in each scale are intended to provide guidelines and examples of signs for every symptom observed. (Does it bother you?) Positive Symptoms are rated on one severity scale while Negative, Disorganized, and General Symptoms are rated using a second severity scale. The Structured Interview for Prodromal Symptoms and the Scale of Prodromal Symptoms are assessment instruments developed for operationally defining diagnosis and for quantitatively rating symptom severity for patients prodromal for psychosis. If the co-occurring diagnosis has been present continuously during the period of positive symptoms, the second test is applied. b. Sense that self, others, the world have changed. Experiences seem meaningful because they recur and will not go away. May seem disengaging or off-putting.Highly unconventional strange behavior or appearance. GENERAL SYMPTOMS G. 1. N NI Y (Record Qualifiers) QUALIFIERS: For all “Y” responses, record: ( Description-Onset-Duration-Frequency ( Degree of Distress: What is this experience like for you? SUSPICIOUSNESS/PERSECUTORY IDEAS Severity Scale (circle one) 0 Absent1 Questionably Present2 Mild3 Moderate 4 Moderately Severe5 Severe but Not Psychotic6 Severe and PsychoticWariness.Concerns about safety. 2 . Page 33 G.2 Dysphoric Mood……………………………………………………………………. Speech mostly monotone. Do you ever feel that it could just be in your head? N NI Y (Record Qualifiers) QUALIFIERS: For all “Y” responses, record: ( Description-Onset-Duration-Frequency ( Degree of Distress: What is this experience like for you? Difficulty in harnessing, sustaining, or shifting focus to new stimuli. At early or prodromal stages, the challenges are even greater, given the subtlety of symptoms present. This is a tool to help you measure your heart health and should be used each year. and you may need to create a new Wiley Online Library account. Do you ever feel that it could just be in your head? II. d. Loosening or paralysis (blocking) of associations may be present and make speech hard to follow or unintelligible. Regarding attenuated psychotic symptoms (APS), previous studies have focused on groups at high clinical risk of psychosis, using the Structured Interview for Prodromal Symptoms (SIPS) (Miller et al., 2003) and the Scale of Prodromal Symptoms (SOPS) to assess prodromal states. Background: This study examines the ability of the Scale of Prodromal Symptoms (SOPS) to differentiate between negative and depression symptoms in a young help-seeking ultrahigh risk (UHR) group. mesmerizing, distressing. Prodromal Questionnaire (PQ) and Structured Interview for Prodromal Syndromes (SIPS) have been used as a two-stage process for identifying subjects at clinical high risk (CHR) of psychosis. Record Response For all responses, record: description, onset, duration, and change over time. (Does it bother you?) A score of “1” to “5” on one or more of scales P1-P5 indicates a Positive Symptoms that is at a non-psychotic level intensity. (2002). Does the patient have any first degree relatives with a psychotic disorder (Schizophrenia, Schizophreniform Disorder, Brief Psychosis, Delusional Disorder, Psychotic Disorder NOS, Schizoaffective Disorder, Psychotic Mania, Psychotic Depression)? Patient’s answers tend to be brief and unembellished, requiring direct and sustained questions by interviewer. c. Occasional frank hallucinations that may minimally influence thinking or behavior. N NI Y (Record Response) For all responses, record: description, onset, duration, and change over time. Symptom Onset (for symptoms rated at a level 3 or higher)Record date when the earliest symptom first occurred: ( Entire lifetime or “ever since I can remember” ( Cannot be determined ( Date of onset ________________/_______ Month Year GLOBAL ASSESSMENT OF FUNCTIONING GAF-M: When scoring consider psychological, social, and occupational functioning on a hypothetical continuum of mental health/illness. At times misses the “gist” of reasonably uncomplicated conversation. Brief Intermittent Psychotic Symptom Psychosis-Risk SyndromeYesNo1.Are any of the SOPS P1-P5 Scales scored 6?2.If Yes to 1, have the symptoms reached a psychotic level of intensity in the past three months?3.If Yes to 1 and 2, are the symptoms currently present for at least several minutes per day at a frequency of at least once per month?4.Are all otherwise qualifying symptoms better explained by another DSM-IV disorder (Axis 1 or 2)?If 1-3 are Yes and 4 is No, the subject meets criteria for Brief Intermittent Psychotic Syndrome. I feel uninterested in the things I used to enjoy. Do you ever feel your eyes are playing tricks on you? Anchors in each scale are intended to provide guidelines and examples of signs for every symptom observed. NO SYMPTOMS: 100 - 91Superior functioning in a wide range of activities Life's problems never seem to get out of hand Sought out by others because of his or her many positive qualities A person doing exceptionally well in all areas of life = rating 95-100 A person doing exceptionally well with minimal stress in one area of life = rating 91-94ABSENT OR MINIMAL SYMPTOMS: 90 - 81Minimal or absent symptoms (e.g. Easily confused by noises, by other people speaking? DESCRIPTION: IMPAIRED TOLERANCE TO NORMAL STRESS a. Avoids or exhausted by stressful situations that were previously dealt with easily. Here we present a structured interview, the Structured Interview for Prodromal Symptoms (SIPS) and a severity scale, the Scale of Prodromal Symptoms (SOPS), to identify operationally the presence of these prodromal constellations and to measure their severity over time, including their conversion to actively psychotic states. (If prefers to be alone, specify reason.) Questionably Present 2 . Unable to become involved with interviewer or maintain conversation despite active questioning by the interviewer.Rating based on: Symptom Onset (for symptoms rated at a level 3 or higher)Record date when the earliest symptom first occurred: ( Entire lifetime or “ever since I can remember” ( Cannot be determined ( Date of onset ________________/_______ Month Year N. 4. Basis for ratings includes both interviewer observations and patient reports. hùSÕ CJ AUDITORY DISTORTIONS, ILLUSIONS, HALLUCINATIONS INQUIRY: 1. N NI Y (Record Qualifiers) 6. N. 2. “Y”) response should be followed by these qualifiers in order to obtain more detailed information. superstitiousness, belief in clairvoyance, telepathy, or “sixth sense”; in children and adolescents, bizarre fantasies or preoccupations)c. Unusual perceptual experiences, including bodily illusions d. Odd thinking and speech (e.g. ( Degree of interference with life: Do you ever act on this experience? Do you ever feel that it could just be in your head? Compulsive motor rituals.Loss of natural movements. Anxiety? Page 34 G.3 Motor Disturbances………………………………………..……………………….. Do you ever feel that people around you are thinking about you in a negative way? parent, full sibling, child)? TROUBLE WITH FOCUS AND ATTENTION Disorganization Symptom Scale 0 Absent1 Questionably Present2 Mild3 Moderate4 Moderately Severe5 Severe 6 ExtremeLapses of focus under pressure.Inattention to everyday tasks or conversations.Problems maintaining focus and attention. Do you seem to feel more sensitive to light or do things that you see ever N NI Y (Record Qualifiers) appear different in color, brightness or dullness; or have they changed in some other way? Preliminary dimension reduction analyses suggested that psychosis‐risk symptoms may deviate from the traditional symptom structure of schizophrenia, but findings have been inconsistent. Initiation or task completion requires some prodding. difficulty concentrating after family argument) Slight impairment in social, work, or school functioning (e.g. Some loosening of associations or blocking. The evidence-based Prodromal Symptoms Screening Scale measures your heart health and identifies early warning signs of heart disease. ( Degree of Conviction/Meaning: How do you account for this experience? (include time to bed, to sleep, and to awake, hours of sleep in a 24-hour period, difficulty falling asleep, early awakening, day/night reversal). RESULTS The mean age of the study population was 24.66±5.62 yr. Prefers being alone.Rating based on: Symptom Onset (for symptoms rated at a level 3 or higher)Record date when the earliest symptom first occurred: ( Entire lifetime or “ever since I can remember” ( Cannot be determined ( Date of onset ________________/_______ Month Year N. 2. Assessment of Cognitive Symptoms in Prodromal and Early Huntington Disease PLOS Currents: Huntington Disease , Jul 2011 Anthony L Vaccarino , Terrence Sills , Karen Anderson , Beth Borowsky , David Craufurd , Joseph Giuliano , LaVonne Goodman , Mark Guttman , Peter Kupchak , Aileen K Ho , et al.

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