Pathways leading to psychosis in 22q11.2 deletion syndrome (22q11.2DS) have been the focus of intensive research during the last two decades. One of the common clinical risk factors for the evolution of psychosis in 22q11.2DS is the presence of positive and negative subthreshold psychotic symptoms. The gold standard for measuring subthreshold symptoms is the Structured Interview for Prodromal Syndromes (SIPS) and its accompanying Scale of Prodromal Symptoms (SOPS) ratings. Although the scale has been used by many centers studying 22q11.2DS, the inter-site reliability of the scale in this population has never been established. In the present study, experienced clinical assessors from three large international centers studying 22q11.2DS independently rated video recordings of 18 adolescents and young adults with 22q11.2DS. The intraclass correlations coefficients (ICCs) among three raters for the SOPS total scores, as well as for the positive, negative, and disorganization subscale scores, were good-to-excellent (ICCs range 0.73–0.93). The raters were also able to reliably determine the subjects’ subthreshold syndrome status (ICC = 0.71). The reliability of individual items was good-to-excellent for all items, ranging from 0.61 for motor disturbances [G3] to 0.95 for bizarre thinking. Our results show that trained clinicians can reliably screen for subthreshold psychotic symptoms in individuals with 22q11.2DS. To increase assessment reliability, we suggest specific clarifications and simplifications to the standard SIPS interview for future studies.

中文翻译：

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22q11.2 缺失综合征个体阈下精神病症状的评估者间可靠性


22q11.2 缺失综合征 (22q11.2DS) 导致精神病的途径一直是过去二十年深入研究的焦点。 22q11.2DS 精神病演变的常见临床危险因素之一是存在阳性和阴性阈下精神病症状。测量阈下症状的黄金标准是前驱综合症结构化访谈 (SIPS) 及其随附的前驱症状量表 (SOPS) 评级。尽管该量表已被许多研究 22q11.2DS 的中心使用，但该量表在该人群中的站点间可靠性尚未确定。在本研究中，来自三个研究 22q11.2DS 的大型国际中心的经验丰富的临床评估员对 18 名患有 22q11.2DS 的青少年和年轻人的视频记录进行了独立评分。三位评分者的 SOPS 总分以及正向、负向和混乱分量表得分的组内相关系数 (ICC) 均为良好至优秀（ICC 范围 0.73-0.93）。评估者还能够可靠地确定受试者的阈下综合征状态（ICC = 0.71）。所有项目的个别项目的可靠性从好到优秀，范围从运动障碍 [G3] 的 0.61 到奇异思维的 0.95。我们的结果表明，经过培训的临床医生可以可靠地筛查 22q11.2DS 个体的阈下精神病症状。为了提高评估可靠性，我们建议对标准 SIPS 访谈进行具体说明和简化，以供未来研究使用。