Positive and Negative Syndrome Scale
The Positive and Negative Syndrome Scale (PANSS) is a medical scale used for measuring symptom severity of patients with schizophrenia. It was published in 1987 by Stanley Kay, Lewis Opler, and Abraham Fiszbein. It is widely used in the study of antipsychotic therapy.
The name refers to the two types of symptoms in schizophrenia, as defined by the American Psychiatric Association: positive symptoms, which refer to an excess or distortion of normal functions (e.g., hallucinations and delusions), and negative symptoms, which represent a diminution or loss of normal functions.
The PANSS is a relatively brief interview, requiring 45 to 50 minutes to administer.[1] The interviewer must be trained to a standardized level of reliability.[2]
Interview items
To assess a patient using PANSS, an approximately 45-minute clinical interview is conducted. The patient is rated from 1 to 7 on 30 different symptoms based on the interview as well as reports of family members or primary care hospital workers.[3]
Positive scale
7 Items, (minimum score = 7, maximum score = 49)
- Delusions
- Conceptual disorganization
- Hallucinations
- Hyperactivity
- Grandiosity
- Suspiciousness/persecution
- Hostility
Negative scale
7 Items, (minimum score = 7, maximum score = 49)
- Blunted affect
- Emotional withdrawal
- Poor rapport
- Passive/apathetic social withdrawal
- Difficulty in abstract thinking
- Lack of spontaneity and flow of conversation
- Stereotyped thinking
General Psychopathology scale
16 Items, (minimum score = 16, maximum score = 112)
- Somatic concern
- Anxiety
- Guilt feelings
- Tension
- Mannerisms and posturing
- Depression
- Motor retardation
- Uncooperativeness
- Unusual thought content
- Disorientation
- Poor attention
- Lack of judgment and insight
- Disturbance of volition
- Poor impulse control
- Preoccupation
- Active social avoidance
PANSS Total score minimum = 30, maximum = 210
Scoring
As 1 rather than 0 is given as the lowest score for each item, a patient can not score lower than 30 for the total PANSS score. Scores are often given separately for the positive items, negative items, and general psychopathology. In their original publication on the PANSS scale, Stanley Kay and colleagues tested the scale on 101 patients with schizophrenia[1] and the mean scores were,
- Positive scale = 18.20
- Negative scale = 21.01
- General psychopathology = 37.74
See also
- Brief Psychiatric Rating Scale (BPRS)
- Scale for the Assessment of Positive Symptoms (SAPS)
- Scale for the Assessment of Negative Symptoms (SANS)
- Diagnostic classification and rating scales used in psychiatry
References
- 1 2 Kay SR, Fiszbein A, Opler LA (1987). "The positive and negative syndrome scale (PANSS) for schizophrenia." (PDF). Schizophr Bull 13 (2): 261–76. doi:10.1093/schbul/13.2.261. PMID 3616518.
- ↑ John Hunsley, Eric J. Mash (2008), A Guide to Assessments that Work, Oxford University Press US, ISBN 0-19-531064-0
- ↑ Kay, Stanley R. (1991), Positive and Negative Syndromes in Schizophrenia, Routledge Mental Health, pp. 33–36, ISBN 0-87630-608-3