ORIGINAL RESEARCH article
Front. Psychol.
Sec. Quantitative Psychology and Measurement
Detection of psychosis risk: reliability and validity of the Spanish version of the interview Comprehensive Assessment of at-Risk Mental States (CAARMS-S).
1. Autonomous University of Barcelona, Barcelona, Spain
2. Serra Húnter Programme, Generalitat de Catalunya, Barcelona, Spain
3. Institut d'Assistencia Sanitaria, Salt, Spain
4. Institut d'Investigacio Biomedica de Girona Dr Josep Trueta, Girona, Spain
5. Department of Applied Mathematics for Information and Communication Technologies, Higher Technical School of Computer Systems Engineering (NEBULA Research Group), Universidad Politecnica de Madrid, Madrid, Spain
6. MIT linQ, Massachusetts Institute of Technology, Cambridge, United States
7. Personality, Assessment and Clinical Psychology Department. School of Psychology., Universidad Complutense de Madrid, Madrid, Spain
8. Department of Research, Associacio Centre d'Higiene Mental Les Corts, Barcelona, Spain
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Abstract
The early identification of psychosis risk is critical, particularly within the first two years of the at-risk phase, as timely intervention may reduce the likelihood of transitioning to psychosis. This study evaluates the reliability and validity of the Spanish version of the Comprehensive Assessment of At-Risk Mental States (CAARMS-S) interview. A prospective longitudinal study was conducted with 36 individuals at Ultra-High Risk (UHR), 43 with First-Episode Psychosis (FEP), and 14 matched controls, all part of the Early Intervention Programme in Catalonia. Data collection involved clinical interviews and multiple validated scales, including CAARMS-S, PANSS, GAF, SCID-II, and K-SADS-PL. Reliability testing showed excellent internal consistency (Cronbach’s α = 0.93) and inter-observer reliability (ICC = 0.92). Construct validity was supported by significant differences in PANSS positive subscale scores among UHR, FEP, and control groups (p < 0.001). Strong correlations were observed between CAARMS-S and PANSS subscales (positive: r = 0.608; negative: r = 0.495; general: r = 0.577). After six months, only one UHR participant (3.3%) transitioned to psychosis. Both CAARMS-S and PANSS were sensitive to changes in positive symptoms, with CAARMS-S being more responsive to negative symptoms and PANSS to general psychopathology. These findings confirm that CAARMS-S is a reliable, valid, and sensitive tool for identifying and monitoring individuals at risk of psychosis in Spanish-speaking clinical settings, supporting its use in early intervention programs.
Summary
Keywords
At-risk, CAARMS, Early detection, First-episode psychosis, psychosis, ultra-high risk, Validation
Received
15 October 2025
Accepted
06 January 2026
Copyright
© 2026 Barajas, Mauri, Cid, Gutiérrez, Calvo and Lalucat. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Ana Barajas
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