Monday, December 19, 2022

10-Item PANSS Appears Reliable for Measuring Schizophrenia Symptoms in Youth

A shortened version of the Positive and Negative Syndrome Scale (PANSS) appears to be a reliable tool for assessing psychosis symptoms in youth, according to a report in Journal of the American Academy of Child and Adolescent Psychiatry.

For the traditional PANSS, an interviewer rates adult patients on 30 measures of positive, negative, and associated cognitive and affective symptoms on a scale of 1 (absent) to 7 (extreme), wrote Robert L. Findling, M.D., M.B.A., of Virginia Commonwealth University and colleagues. With younger patients, the interviewer relies on interviews with both the patients as well as their primary caregivers.

“The [30-item] PANSS has a venerable tradition of use, but it is decades old, and was designed for use with adult patients,” Findling and colleagues continued. To create the shortened PANSS, the researchers selected two items from each of the five PANSS symptom domains: positive symptoms, negative symptoms, excited symptoms, cognitive symptoms, and depression/anxiety symptoms. The 10-item scale assessed delusions and unusual thoughts (positive symptoms), emotional withdrawal and apathy (negative symptoms), hostility and poor impulse control (excited symptoms), inattention and disorganized thinking (cognitive symptoms), and anxiety and guilt feelings (depression/anxiety symptoms).

Findling and colleagues tested the 10-item scale using data from an eight-week clinical trial that compared the safety and efficacy of several antipsychotics in 118 youth aged 9 to 19 years with schizophrenia or schizoaffective disorder. In that study, the participants were assessed with the 30-item PANSS every week. The researchers found that the 10-item scale matched the full 30-item scale almost 90% of the time and was accurate for both mild and severe symptom scores.

“The shorter version is likely to be more popular in clinical practice, given time and fiscal constraints, and more popular with families …,” Findling and colleagues concluded. “For pediatric trials and clinical assessment, using the optimized [shortened] PANSS will maintain treatment sensitivity and precision while reducing costs, shortening interviews, reducing burden, and improving score validity.”

To read more about this topic, see the Psychiatric Research and Clinical Practice article “Shortened Positive and Negative Symptom Scale as an Alternate Clinical Endpoint for Acute Schizophrenia Trials: Analysis from the US Food & Drug Administration.”

(Image: iStock/skynesher)

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