IEPA 11

Cameron S. Carter1, Tara A. Niendam1, Rachel Loewy2, Mark Savill2, Monet Meyer1, Adi Rosenthal1, Kevin Delucchi2, Tyler A. Lesh1, Haley Skymba1, Daniel Ragland1, Howard H. Goldman3, Richard L. Kravitz4; 1Department of Psychiatry, University of California, Davis School of Medicine, Sacramento, CA, USA, 2Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, CA, USA, 3Department of Psychiatry, University of Maryland School of Medicine, USA, 4Department of Internal Medicine, University of California, Davis School of Medicine, Sacramento, CA, USA
           
The present cluster-randomized controlled trial assesses whether adding a novel technology-enhanced screening using the Prodromal Questionnaire-Brief version (PQ-B) to standard provider education identifies more individuals with first episode psychosis (FEP), earlier in their illness. Twenty-two sites were randomized within 3 strata [community mental health, CMH (N=10), middle/high schools, SCH (N=8), primary care, PC (N=4)] to an Education alone (TAU) vs Education + Electronic Screening (Active)]. Active sites screened individuals ages 12-30 referred those who passed a liberal PQ-B cut off score for phone evaluation. TAU sites referred individuals for phone evaluation based on clinician judgment. Phone evaluations assessed eligibility for FEP services and duration of untreated psychosis (DUP).  Active sites effectively implemented electronic screening. Of the 822 individuals screened at Active sites between June 2015 and July 2017, 43.2% scored above the cutoff (mean ±SD PQ-B score=21.25±20.75).  One in 8 individuals who completed the tablet were identified with threshold psychosis. Across Active and TAU sites, 511 individuals were identified, 422 agreed to be referred, and 319 completed a phone interview: 33.23% reported attenuated and 36.68% fully psychotic symptoms.  Active sites identified significantly more individuals with threshold psychosis (p<.001) than TAU. DUP was relatively short in both groups (186 days in Active and 195 days in TAU). No difference in days of DUP was observed across arms. Preliminary results show the feasibility of electronic screening across various community settings and a 3.5 times higher identification rate for electronic screening of self-reported psychosis spectrum symptoms than clinician-based identification alone.