The Development of Questionnaire for Relapse Assessment in Psychotic Disorder

Kee Jeong Park; Un Jung Cho; Jung Sun Lee; Yeon Ho Joo; Chang Yoon Kim

doi:10.4306/jknpa.2013.52.6.417

Journal List > J Korean Neuropsychiatr Assoc > v.52(6) > 1017657

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Park, Cho, Lee, Joo, and Kim: The Development of Questionnaire for Relapse Assessment in Psychotic Disorder

Original Article

Journal of Korean Neuropsychiatric Association 2013; 52(6): 417-430.

Published online: 30 November 2013

DOI: https://doi.org/10.4306/jknpa.2013.52.6.417

The Development of Questionnaire for Relapse Assessment in Psychotic Disorder

Kee Jeong Park, MD, Un Jung Cho, MD, Jung Sun Lee, MD, PhD, Yeon Ho Joo, MD, PhD, Chang Yoon Kim, MD, PhD

Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Address for correspondence: Chang Yoon Kim, MD, PhD. Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea. Tel +82-2-3010-3416, Fax +82-2-485-8381, cykim@amc.seoul.kr

Received 28 June 2013 Revised 9 September 2013 Accepted 25 September 2013

Abstract

Objectives

The aims of this study were to develop an instrument for detection of relapse in psychotic disorder and to validate the instrument.

Methods

A total of 55 outpatients with psychotic disorder (schizophrenia, schizoaffective disorder, bipolar disorder) and 46 of their caregivers were enrolled. We developed the Questionnaire for Relapse Assessment in Psychotic disorder (QRAP), a self/report inventory. The patients and caregivers drew up the QRAP at two different time points, 'current' and 'the best state during the past three months'. In addition, we rated other established scales in order to evaluate psychotic and mood symptoms of patients. We divided patients into two groups, stable (n=30) and impending relapse (n=35) and evaluated the effectiveness of QRAP by calculating sensitivity and specificity.

Results

For all patients and caregivers, QRAP total score at 'current' was higher than 'the best state during the past three months' and showed significant positive correlation with other established scales. As expected, QRAP total score at 'current' in the impending relapse group was higher than that of the stable group. With cut off criteria 1, the QRAP demonstrated 80.0% sensitivity and 56.3% specificity in caregivers and effectively detected impending relapse.

Conclusion

The results of our study suggest the effectiveness of QRAP as an instrument for detection of relapse in patients with psychotic disorder.

Keywords: Psychotic disorder, Relapse assessment, Screening test

Figures and Tables

Fig. 1

Changes in Questionnaire for Relapse Assessment in Psychotic disorder (QRAP) total scores between stable group and impending relapse group [(A) by patients and (B) by caregivers]. Baseline means the best state during past 3 months.

Table 1

Demographic and clinical characteristics of stable group and impending relapse group

^* : Using Mann-Whitney U-test. CGI-S : Clinical Global Impression-Severity, HAMD-17 : Hamilton Rating Scale for Depression-17, PANSS : Positive and Negative Syndrome Scale, SD : Standard deviation, YMRS : Young Mania Rating Scale

Table 2

Comparisons of sensitivity and specificity between schizophrenia patients and bipolar disorder patients

Criteria 1 : ≥3 on change in total scores between 'current' and 'the best state during past 3 months'. Criteria 2 : one of the following ; 1) ≥3 on change in total scores between 'current' and 'the best state during past 3 months' and (≥3 on the number of scored 2, ≥2 on the number of scored 3, or ≥1 on the number of scored 4), 2) ≥3 on change in total scores between 'current' and 'the best state during past 3 months' and (≥2 on the number of scored 3 on item No. 10-14), 3) ≥ score 2 on the item No. 15

Table 3

Correlation analysis between Questionnaire for Relapse Assessment in Psychotic disorder (QRAP) and other established scales with diagnosis

BD : Bipolar disorder, CGI-S : Clinical Global Impression-Severity, HAMD-17 : Hamilton Rating Scale for Depression-17, PANSS : Positive and Negative Syndrome Scale, SPR : Schizophrenia, YMRS : Young Mania Rating Scale

Notes

The authors have no financial conflicts of interest.

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