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 efficacy.2
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 efficacy.2
Disease States: Schizophrenia
Validated Uses: Treatment Monitoring & Evaluation, Symptom Severity
Administration Method: Clinician-report
Time to administer: 30–40 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 to 49, and the range for the General Psychopathology Scale is 16 to 112. The composite scale can be between -42 and +42 based on the clinician subtracting the negative score from the positive score.5 The positive and negative scales tend to be mutually exclusive.5
Scale Validity: In a validation study of 82 acute and chronic schizophrenics, the PANSS demonstrated high interrater reliability in the 0.80s. 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 receives a rating of 1 to 7. A score of ≥ 70 is typically considered symptomatic.7
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 advances.8

Footnotes:

Supporting references are as follows:
Disease State: Schizophrenia1; Validated Uses: Research1; Administration Method: Clinician or trained mental health professional1-6; Time to Administer: 30-40 minutes3; Commonly used in: Research1; Populations: Adults,4 Children2,7; Cited Limitations4,8
 

This resource is intended for educational purposes only and is intended for US healthcare professionals. Healthcare professionals should use independent medical judgment. All decisions regarding patient care must be handled by a healthcare professional and be made based on the unique needs of each patient. 
 

ABBV-US-01568-MC, Version 2.0
Approved 04/2024
AbbVie Medical Affairs 

References:

  1. Kumari S, Malik M, Florival C, Manalai P, Sonje S. An assessment of five (PANSS, SAPS, SANS, NSA-16, CGI-SCH) commonly used symptoms rating scales in schizophrenia and comparison to newer scales (CAINS, BNSS). J Addict Res Ther. 2017;8(3). doi:10.4172/2155-6105.1000324 
  2. Opler M, Yavorsky C, Daniel DG. Positive and Negative Syndrome Scale (PANSS) training: challenges, solutions, and future directions. Innov Clin Neurosci. 2017;14(11-12):77-81. 
  3. Fields JH, Grochowski S, Lindenmayer P, et al. Assessing positive and negative symptoms in children and adolescents. Am J Psychiatry. 1994;151(2):249-253. doi:10.1176/ajp.151.2.249 
  4. CADTH. A Systematic Review of Combination and High-Dose Atypical Antipsychotic Therapy in Patients with Schizophrenia. CADTH Optimal Use Report, No. 1.1B. Canadian Agency for Drugs and Technologies in Health; 2011:65-66. 
  5. Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bull. 1987;13(2):261-76. doi:10.1093/schbul/13.2.261 
  6. Kay SR, Opler LA, Lindenmayer JP. Reliability and validity of the positive and negative syndrome scale for schizophrenics. Psychiatry Res. 1988;23(1):99-110. doi:10.1016/0165-1781(88)90038-8 
  7. Hirshtritt M, Bedoya MA. Symptom-specific rating scales in child and adolescent psychiatry clinical practice. Child and Adolescent Psychopharmacology News. Accessed March 28, 2024. https://guilfordjournals.com/doi/pdfplus/10.1521/capn.2011.16.4.6 
  8. Aboraya A, Nasrallah HA. Perspectives on the Positive and Negative Syndrome Scale (PANSS): Use, misuse, drawbacks, and a new alternative for schizophrenia research. Ann Clin Psychiatry. 2016;28(2):125-131. 

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