The approved Italian version of the comprehensive assessment of at-risk mental states (CAARMS-ITA): Field test and psychometric features

Abstract

Aim: The Comprehensive Assessment of At-Risk Mental States (CAARMS) was specifically developed to assess and detect young people at ultra-high risk (UHR) of developing psychosis. The current study was undertaken to test the reliability and validity of the authorized Italian version of the CAARMS (CAARMS-ITA) in a help-seeking population. Methods: Psychometric properties of the CAARMS-ITA were established using a sample of 223 Italian adolescents and young adults aged between 13 and 35 years, who were divided into 3 groups according to the CAARMS criteria: UHR-negative individuals (UHR [−]; n = 64), UHR-positive (UHR [+]; n = 55) and individuals with a first-episode psychosis (FEP; n = 104). The CAARMS-ITA's reliability was tested measuring interrater reliability and internal consistency. Construct validity was tested comparing the Positive and Negative Syndrome Scale (PANSS) and CAARMS-ITA subscale scores across groups (ie, UHR [−], UHR [+] and FEP). For concurrent validity, we studied correlations between symptoms of the CAARMS-ITA and their equivalents in the PANSS. Finally, the predictive validity was examined by following up with UHR [+] individuals. The 12-month transition rate to psychosis was calculated. Results: The CAARMS-ITA showed good interrater reliability. The PANSS “Positive Symptoms” subscale scores in UHR [+] individuals were intermediate between FEP and UHR [−] groups. The positive and negative symptoms scores of the CAARMS-ITA significantly correlated with the corresponding scores of the PANSS. After 12 months, 4 of 41 (9.8%) UHR [+] individuals had transitioned to psychosis. Conclusions: The CAARMS-ITA is a reliable and valid instrument for assessing and detecting at-risk mental states in Italian clinical settings. It also appears to be helpful in the prediction of psychosis transition.