Interrater reliability of the authorized Italian version of the Comprehensive Assessment of At-Risk Mental States (CAARMS-ITA)

Objective The Comprehensive Assessment of At-Risk Mental States (CAARMS) was specifically developed to detect and assess young individuals at Ultra-High Risk (UHR) of psychosis. Aim of the current study was to test the interrater reliability of the authorized Italian version of the CAARMS (CAARMS-ITA) in young adult help-seekers consecutively recruit through the “Reggio Emilia At-Risk Mental States” (ReARMS) project, an early detection and intervention infrastructure developed in the Reggio Emilia Department of Mental Health. Methods We included 51 young adults, aged 18-35 years, seeking help at the Reggio Emilia outpatient mental health services. Two trained raters were paired for each CAARMS interview, both simultaneously in the room with the subject. Interrater reliability of the CAARMS-ITA was tested measuring the Intra-Class Correlation (ICC) coefficients and the Cohen’s kappa for interrater agreement on CAARMS-defined diagnosis criteria (i.e. UHR and First-Episode Psychosis [FEP]). Results The CAARMS-ITA showed an excellent interrater reliability. The Cohen’s kappa for CAARMS diagnoses was 0.845 (p < 0.001). The ICC coefficients of the seven CAARMS subscale scores ranged from 0.965 and 0.990. Conclusions The CAARMS-ITA is a reliable instrument for detecting and assessing at-risk mental states in Italian clinical setting.