AIM: The importance of early intervention in psychiatry is widely recognised among psychiatrists. However, it is unknown whether precise knowledge of at-risk mental state has been disseminated. With this survey, we aimed to reveal how Japanese psychiatrists diagnosed patients with at-risk mental state and prescribed treatment strategies for them.
METHODS: Using fictional case vignettes, we conducted a questionnaire survey of psychiatrists (n = 1,399) who worked in Tokyo. We mailed study documents to all eligible participants in November 2015 with a requested return date in December.
RESULTS: Two hundred and sixty (19.3%) psychiatrists responded to the survey. Their correct diagnosis rates for the at-risk mental state vignettes were low (14.6% for the vignette describing at-risk mental state with attenuated positive symptom syndrome and 13.1% for the vignette describing at-risk mental state with brief intermittent psychotic syndrome). Many psychiatrists selected pharmacotherapy and antipsychotics to treat the at-risk mental state vignettes. The psychiatrists who correctly diagnosed the at-risk mental state vignettes had significantly fewer years of clinical psychiatric experience than did those who diagnosed them as non- at-risk mental state (12.5 years vs 22.7 years for the vignette describing at-risk mental state with attenuated positive symptom syndrome, p < 0.01; 14.3 years vs 22.2 years for the vignette describing at-risk mental state with brief intermittent psychotic syndrome, p < 0.01).
CONCLUSION: This study suggested that precise knowledge of at-risk mental state has not been disseminated among Japanese psychiatrists.
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