The PANSS and other scales

PANSS

The Positive and Negative Syndrome Scale (PANSS) is one of the most widely used measures of psychopathology of schizophrenia in clinical research. Since its development, the PANSS has become a benchmark when screening and assessing change, in both clinical and research patients. It is a 30-item scale used to evaluate the presence, absence and severity of Positive, Negative and General Psychopathology symptoms of schizophrenia. The 30 items are arranged as seven positive symptom subscale items, seven negative symptom subscale items, and 16 general psychopathology symptom items. Each item has a definition and a basis for rating. All 30 items are rated on a 7-point scale (1 = absent; 7 = extreme). The strengths of the PANSS include its structured interview, robust factor dimensions, reliability, the availability of detailed anchor points, and validity. The PANSS is accompanied by a semi-structured interview, the SCI-PANSS, to ensure that all content domains are covered during the interview session.

SCI-SR

The Structured Clinical Interview for Symptoms of Remission for the PANSS (SCI-SR) is a brief interview that may be used in research and treatment settings to assess remission based on eight PANSS items. Informant data is required to confirm functional status on 4 of the 8 items. This data may be collected from third party sources (nursing staff, families, caregivers) or provided by the clinician conducting the interview (assuming sufficient patient contact has occurred in the prior period of interest). Each item is rated using the well-validated criteria and anchoring points for each as described in the PANSS Manual©. Unlike the SCI-PANSS, the SCI-SR may be administered in approximately 15 minutes or less. Based on Andreasen et al. (2005), remission is defined as a score of 3 (Mild) or less for each item, maintained over 6 month period.

SOTS

The Symptoms of Trauma Scale (SOTS) is a 9-item 7-point rating scale that can be used to measure severity, ranging from absent to extreme, of nine symptoms previously shown to be associated with trauma. Since the SOTS is not a diagnostic interview, it cannot be used to establish a diagnosis of Post-traumatic Stress Disorder (PTSD) and/or Complex PTSD. Rather, the SOTS it is designed to be used to complement existing systems that establish trauma history as well as diagnosis.

Ratings for nine symptoms range from: 1=Absent to 7=Extreme. Because the SOTS provides a means of rating of symptoms at seven levels of severity (absent, minimal, mild, moderate, moderate severe, severe, and extreme), the SOTS can assess changes in trauma symptoms. This will become increasingly important as new treatments, both psychosocial and pharmacological, emerge to treat PTSD and other trauma related disorders.

The Symptom Specific Group Therapy, or SSGT is a set of six manuals designed by Dr. Anne-Marie Shelley. Each manual focuses on one symptom category of schizophrenia, including Positive symptoms, Negative symptoms, Trauma symptoms, Activation symptoms, Dysphoria, and Autistic Preoccupation. Each manual is intended to guide a group leader and/or co-leader in conducting group cognitive behavioral therapy sessions for patients who exemplify the specific symptoms for that group’s symptom module. Each group is intended to last approximately 12 weeks (based on group meetings once a week), and involved both interactive and teaching components. The SSGT-based program is currently being utilized at the Bronx Psychiatric Center, and is quickly gaining momentum in the realm of cognitive behavioral therapy nationwide.