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Scales for the Assessment of Negative Symptoms (SANS)

The Scales for the Assessment of Negative Symptoms (SANS) is a 25-item assessment tool to measure negative symptoms in schizophrenia. The scale was developed in the early 1980s.
Description: The Scales for the Assessment of Negative Symptoms (SANS) is a 25-item assessment tool to measure negative symptoms in schizophrenia. The scale was developed in the early 1980s.
Disease States: Schizophrenia
Validated Uses: Screening, Treatment Monitoring & Evaluation, Symptom Severity
Administration Method: Clinician-report
Time to administer: 20 minutes
Commonly used in: Clinical Trials & Research, Clinical Practice
Detailed Description: The SANS is a scale that mental health professionals use to measure negative symptoms for patients with schizophrenia. The scale measures 25 items of negative symptoms across 5 categories: affective blunting, alogia, avolition-apathy, anhedonia-asociality, and inattention.1 Each item is rated on a scale from 0 (none) to 5 (severe) or unknown/cannot be assessed/not assessed5. It is intended to cover the previous month2. In psychopharmacological research, it can be used weekly to document treatment response.6
The clinician should also use other information sources in addition to the interview, including direct observation, family reports, and nursing reports.2
Scale Validity: The question of reliability and validity of the SANS have been conducted in multiple studies. Earlier studies found interrater reliability to be consistent.1
Alternative Versions: The SANS is complemented by the Scale for the Assessment of Positive Symptoms (SAPS) which is a similar tool that evaluates positive symptoms. Together the scales are a comprehensive combination that can measure schizophrenia symptoms and assess changes over time1.
Cited Limitations: One criticism is that the duality of positive and negative scales is not diverse or complex enough for schizophrenia symptoms1.


Supporting references are as follows:
Disease State: Schizophrenia1-7; Validated Uses: Research and clinician use1; Populations: Adult1 and children2; Administration Method: Clinician or trained mental health professional1-8; Time to Administer: varies1, 20 minutes4; Commonly used in: Research4; Alternative Versions: Cited Limitations8


  1. Kumari S, et al. J Addict Res Ther. 2017; 8(3).doi:10.4172/2155-6105.1000324. 
  2. Andreasen NC. Arch Gen Psychiatry. 1982; 39 (7): 784-8. doi: 10.1001/archpsyc.1982.04290070020005.
  3. Schoemaker J, et al. An Interview Guide for the Scale for Assessment of Negative Symptoms (IG-SANS). ISCTM 6th Annual Scientific Meeting. 2010. https://cognitiongroup.com/publication/Interview-Guide-for-IG-SANS.pdf
  4. Andreasen NC, et al. Negative vs Positive Schizophrenia. 1991: 28-51.
  5. Scale for the Assessment of Negative Symptoms. https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/GetPdf.cgi?id=phd000807.2

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