Positive and Negative Syndrome Scale (PANSS)

The Positive and Negative Syndrome Scale (PANSS) is a rating scale, designed on the premise that schizophrenia comprises of: positive syndrome, pertaining to productive symptoms; and negative syndrome, pertaining to deficit features (Depp et al, 2010). This clinical tool is employed: 1) upon an inpatient’s admission 2) at the outset of taking a new medication and 3) weeks/ months into treatment to gauge the effect of the intervention (Opler et al., 2006). PANSS has been published officially across 40 languages following internationally valued and sanctioned guidelines under the Multi Health Systems (MHS) Translation Policy (Khan et al, 2013). Validation studies conducted in 1994, conducted reliability and validity studies among 100 DSM-III-R schizophrenic patients. Cuesta and Peralta (1994) much like Opler (1987) found that the scores were normally distributed; while the construct validity was adequate, the positive and negative subscales when compared to Scales for the Assessment of Positive/Negative Symptoms, depicted high criterion validity. However the internal consistency was insufficient and factorial validity of the positive scale was poor. The scale was seemingly developed on the basis of independent components; furthermore, it oversimplified the negative and positive symptoms. PANSS has since had alternate versions released – PANSS – SCI which accompanies a structured clinical interview and IQ –PANSS, which acquires information from informants such as family/case workers (MHS, 2006). Despite complications with respect to length and ability to measure cognitive functioning, PANSS is considered a competent “stand-alone” clinical screening tool for psychosis due to its clinical predicting power and outcome.

Newer studies communicate the following psychometric properties:
Adequate Internal consistencies for positive (α = 0.73: Acceptable), negative (α = 0.83: Good), and general psychopathology (α = 0.79: Good) subscales. Good test-retest reliability with Pearson correlation coefficients at 0.80, 0.68, and 0.60 for the positive, negative and psychopathology subscales. Positive and negative scales showed good inter-rater reliability. Interclass correlation coefficients of 0.72 and 0.80, respectively. Inter-rater reliability was moderate (0.56) for the general psychopathology scale.

References

Canadian Agency for Drugs and Technologies in Health. (2011) A systematic review of combination and high dose atypical antipsychotic therapy in patients with schizophrenia. Ottawa: CADTH

Cuesta, M. J., & Peralta, V. (1995). Psychopathological dimensions in schizophrenia. Schizophrenia Bulletin, 21(3), 473-482.

Kay SR, Opler LA, Fiszbein A. Positive and Negative Syndrome Scale (PANSS; 2006) manual. Toronto, Ontario: MultiHealth Systems, Inc.

Khan, A., Christian Yavorsky, C., Liechti, S., Opler, M., Rothman, B., Diclemente, G., Lucic, L., Jovic, S., Inada, T. and Yang, L. (2013). Available at: http://A rasch model to test the cross-cultural validity in the positive and negative syndrome scale (PANSS) across six geo-cultural groups [Accessed 17 Sep. 2017].

Kumari S, Malik M, Florival C, Manalai P, Sonje S (2017) 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 8: 324. doi: 10.4172/2155-6105.1000324

Maust, D., Cristancho, M., Gray, L., Rushing, S., Tjoa, C. and Thase, M. (2012). Psychiatric rating scales. [online] Experts.umich.edu. Available at: https://experts.umich.edu/en/publications/psychiatric-rating-scales [Accessed 17 Sep. 2017].

Opler, L. A., Opler, M. G. and Malaspina, D. 2006. Reducing guesswork in schizophrenia treatment: PANSS can target and gauge therapy, predict outcomes in clinical practice. Current Psychiatry, 5: 76–84.

Taylor, Grantley W; McCarley, Robert W; Salisbury, Dean F (2013) Early auditory gamma band response abnormalities in first hospitalized schizophrenia. Suppl Clin Neurophysiol 62:131-45