Utility of Washington Early Recognition Center (WERC) Self-Report Screening Questionnaires in the Assessment of Patients with Schizophrenia and Bipolar Disorder

Early identification and treatment are associated with improved outcomes in bipolar disorder and schizophrenia. Screening for the presence of these disorders usually involves time-intensive interviews that may not be practical in settings where mental health providers are limited. Thus, individuals...

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Main Authors: Christina Jen-Chia Hsieh, Douglass Godwin, Daniel Mamah
Format: Article
Language:English
Published: Frontiers Media S.A. 2016-08-01
Series:Frontiers in Psychiatry
Subjects:
Online Access:http://journal.frontiersin.org/Journal/10.3389/fpsyt.2016.00149/full
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author Christina Jen-Chia Hsieh
Christina Jen-Chia Hsieh
Douglass Godwin
Daniel Mamah
author_facet Christina Jen-Chia Hsieh
Christina Jen-Chia Hsieh
Douglass Godwin
Daniel Mamah
author_sort Christina Jen-Chia Hsieh
collection DOAJ
description Early identification and treatment are associated with improved outcomes in bipolar disorder and schizophrenia. Screening for the presence of these disorders usually involves time-intensive interviews that may not be practical in settings where mental health providers are limited. Thus, individuals at earlier stages of illness are often not identified. The Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen is a self-report questionnaire originally developed to identify clinical risk for developing bipolar or psychotic disorders. The goal of the current study was to investigate the utility of the WERCAP Screen and two complementary questionnaires, the WERC Stress Screen and the WERC Substance Screen, in identifying individuals with established schizophrenia or bipolar disorder. Participants consisted of 35 bipolar disorder (BPD) and 34 schizophrenia (SCZ) patients, as well as 32 controls (CON), aged 18-30 years. Univariate analyses were used to test for score differences between groups. Logistic regression and ROC curves were used to identify diagnostic predictors. Significant group differences were found for the psychosis section of the WERCAP (pWERCAP; p < 0.001), affective section of the WERCAP (aWERCAP; p = 0.001), and stress severity (p = 0.027). No significant group differences were found in the rates of substance use as measured by the WERC Substance Screen (p = 0.267). Only the aWERCAP and pWERCAP scores were useful predictors of diagnostic category. ROC curve analysis showed the optimal cut-point on the aWERCAP to identify bipolar disorder among our participant groups was a score of >20 (AUC: 0.87; sensitivity: 0.91; specificity: 1.0); while that for the pWERCAP to identify schizophrenia was a score of >13 (AUC: 0.89; sensitivity: 0.88; specificity: 0.88). These results indicate that the WERCAP Screen may be useful in screening individuals for bipolar disorder and schizophrenia, and that identifying stress and substance use severity can be rapidly done using self-report questionnaires. Larger studies in undiagnosed individuals will be needed to test the WERCAP Screen’s ability to identify mania or psychosis in the community.
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spelling doaj.art-02f45a91b49b4dca85e71165a1ca7ae52022-12-22T00:51:43ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402016-08-01710.3389/fpsyt.2016.00149217272Utility of Washington Early Recognition Center (WERC) Self-Report Screening Questionnaires in the Assessment of Patients with Schizophrenia and Bipolar DisorderChristina Jen-Chia Hsieh0Christina Jen-Chia Hsieh1Douglass Godwin2Daniel Mamah3Saint Louis University School of MedicineWashington University Medical SchoolWashington University Medical SchoolWashington University Medical SchoolEarly identification and treatment are associated with improved outcomes in bipolar disorder and schizophrenia. Screening for the presence of these disorders usually involves time-intensive interviews that may not be practical in settings where mental health providers are limited. Thus, individuals at earlier stages of illness are often not identified. The Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen is a self-report questionnaire originally developed to identify clinical risk for developing bipolar or psychotic disorders. The goal of the current study was to investigate the utility of the WERCAP Screen and two complementary questionnaires, the WERC Stress Screen and the WERC Substance Screen, in identifying individuals with established schizophrenia or bipolar disorder. Participants consisted of 35 bipolar disorder (BPD) and 34 schizophrenia (SCZ) patients, as well as 32 controls (CON), aged 18-30 years. Univariate analyses were used to test for score differences between groups. Logistic regression and ROC curves were used to identify diagnostic predictors. Significant group differences were found for the psychosis section of the WERCAP (pWERCAP; p < 0.001), affective section of the WERCAP (aWERCAP; p = 0.001), and stress severity (p = 0.027). No significant group differences were found in the rates of substance use as measured by the WERC Substance Screen (p = 0.267). Only the aWERCAP and pWERCAP scores were useful predictors of diagnostic category. ROC curve analysis showed the optimal cut-point on the aWERCAP to identify bipolar disorder among our participant groups was a score of >20 (AUC: 0.87; sensitivity: 0.91; specificity: 1.0); while that for the pWERCAP to identify schizophrenia was a score of >13 (AUC: 0.89; sensitivity: 0.88; specificity: 0.88). These results indicate that the WERCAP Screen may be useful in screening individuals for bipolar disorder and schizophrenia, and that identifying stress and substance use severity can be rapidly done using self-report questionnaires. Larger studies in undiagnosed individuals will be needed to test the WERCAP Screen’s ability to identify mania or psychosis in the community.http://journal.frontiersin.org/Journal/10.3389/fpsyt.2016.00149/fullBipolar DisorderSchizophreniastresspsychosisquestionnaireWERCAP
spellingShingle Christina Jen-Chia Hsieh
Christina Jen-Chia Hsieh
Douglass Godwin
Daniel Mamah
Utility of Washington Early Recognition Center (WERC) Self-Report Screening Questionnaires in the Assessment of Patients with Schizophrenia and Bipolar Disorder
Frontiers in Psychiatry
Bipolar Disorder
Schizophrenia
stress
psychosis
questionnaire
WERCAP
title Utility of Washington Early Recognition Center (WERC) Self-Report Screening Questionnaires in the Assessment of Patients with Schizophrenia and Bipolar Disorder
title_full Utility of Washington Early Recognition Center (WERC) Self-Report Screening Questionnaires in the Assessment of Patients with Schizophrenia and Bipolar Disorder
title_fullStr Utility of Washington Early Recognition Center (WERC) Self-Report Screening Questionnaires in the Assessment of Patients with Schizophrenia and Bipolar Disorder
title_full_unstemmed Utility of Washington Early Recognition Center (WERC) Self-Report Screening Questionnaires in the Assessment of Patients with Schizophrenia and Bipolar Disorder
title_short Utility of Washington Early Recognition Center (WERC) Self-Report Screening Questionnaires in the Assessment of Patients with Schizophrenia and Bipolar Disorder
title_sort utility of washington early recognition center werc self report screening questionnaires in the assessment of patients with schizophrenia and bipolar disorder
topic Bipolar Disorder
Schizophrenia
stress
psychosis
questionnaire
WERCAP
url http://journal.frontiersin.org/Journal/10.3389/fpsyt.2016.00149/full
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