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Positive and Negative Syndrome Scale (PANSS)

The Positive and Negative Syndrome Scale (PANSS) for schizophrenia is a 30-item instrument that allows providers to measure a patient’s clinical response to pharmacological treatment.1 It is considered to be commonly used for assessing antipsychotic treatment efficacy2
Description: The Positive and Negative Syndrome Scale (PANSS) for schizophrenia is a 30-item instrument that allows providers to measure a patient’s clinical response to pharmacological treatment.1 It is considered to be commonly used for assessing antipsychotic treatment efficacy2
Disease States: Schizophrenia
Validated Uses: Treatment Monitoring & Evaluation, Symptom Severity
Populations: Adult, Pediatric
Administration Method: Clinician-report
Time to administer: 30+ minutes
Commonly used in: Clinical Trials & Research, Clinical Practice
Detailed Description: The PANSS is a 30-item clinician-administered rating scale.It adapted 12 items from the Psychopathology Rating Schedule (PRS) and 18 items from the Brief Psychiatric Rating Scale (BPRS). It includes 3 subscales: Positive Scale, Negative Scale, and General Psychopathology Scale. Each item is rated with 1 to 7 points ranging from absent to extreme. 5 The range for the Positive and Negative Scales is 7-49, and the range for the General Psychopathology Scale is 16-112. The composite scale can be between -42 to +42, based on the clinician subtracting the negative score from the positive score.5 The positive and negative scales tend to be mutually exclusive5.
Scale Validity: In a validation study of 82 acute and chronic schizophrenics, the PANSS demonstrated high interrater reliability in the 0.80’s. The results cross-validated previous findings and supported the reliability and validity of PANSS.6
Alternative Versions: Kiddie-PANSS is available for use with children and adolescents. The tool is designed to assess the severity of the child’s symptoms over the past 7 days, using a clinician-rated 30 item scale. Each item receiving a 1-7 rating. A score of ≥70 is typically considered symptomatic7.
Cited Limitations: Researchers have said it is not clear what degree of improvement in the total or subscale PANSS scores is clinically important. Some also claim that it’s not clear what the relationship is between a patient’s long-term clinical outcome and PANSS score changes.4 Research has indicated a new instrument is needed that is compatible with clinical neuroscience research advances8.

Footnotes:

Supporting references are as follows:
Disease State: Schizophrenia 1; Validated Uses: Research 1; Populations: Adult 4 and children 2; Administration Method: Clinician or trained mental health professional 1-6; Time to Administer: 30-40 minutes 3; Commonly used in: Research 1; Cited Limitations 6
 

References:

  1. Kumari S, et al. J Addict Res Ther. 2017; 8(3).doi:10.4172/2155-6105.1000324
  2. Opler M, et al. Innov Clin Neurosci. 2017; 14 (11-12): 77-81.
  3. Am J Psychiatry. 1994; 151(2): 249-253.
  4. CADTH. Systematic Review of Combination and High-Dose Atypical Antipsychotic Therapy in Patients with Schizophrenia. 2011; 1(1B): 65-66.
  5. Kay SR, et al. Schizophrenia Bull. 1987; 13(2): 261-76.
  6. Kay SR, et al. Psychiatry Res. 1988; 23(1):99-110.
  7. Hirshtritt M. Child and Adolescent Psychopharmacology News:  https://guilfordjournals.com/doi/pdfplus/10.1521/capn.2011.16.4.6
  8. Aboraya A. Ann Clin Psychiatry. 2016; 28(2):125-131.

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