The Positive and Negative Syndrome Scale (PANSS) is a medical scale used for measuring symptom severity of patients with

schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social w ...

. It was published in 1987 by Stanley Kay, Lewis Opler, and Abraham Fiszbein. It is widely used in the study of

antipsychotic Antipsychotics, also known as neuroleptics, are a class of psychotropic medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizophrenia but also in a range of ...

therapy. The scale is known as the "gold standard" that all assessments of psychotic behavioral disorders should follow. The name refers to the two types of symptoms in schizophrenia, as defined by the

American Psychiatric Association The American Psychiatric Association (APA) is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the largest psychiatric organization in the world. It has more than 37,000 members are invo ...

: positive symptoms, which refer to an excess or distortion of normal functions (e.g.,

hallucination A hallucination is a perception in the absence of an external stimulus that has the qualities of a real perception. Hallucinations are vivid, substantial, and are perceived to be located in external objective space. Hallucination is a combinati ...

s and

delusion A delusion is a false fixed belief that is not amenable to change in light of conflicting evidence. As a pathology, it is distinct from a belief based on false or incomplete information, confabulation, dogma, illusion, hallucination, or som ...

s), and

negative symptom Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showi ...

s, which represent a diminution or loss of normal functions. Some of these functions which may be lost include normal thoughts, actions, ability to tell fantasies from reality, and the ability to properly express emotions. The PANSS is a relatively brief interview, requiring 45 to 50 minutes to administer. The interviewer must be trained to a standardized level of reliability.

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.

Positive scale

7 Items, (minimum score = 7, maximum score = 49) * Delusions * Conceptual disorganization * Hallucinations * Excitement * 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 adult patients (20-68 years-old) with schizophrenia and the mean scores were, * Positive scale = 18.20 * Negative scale = 21.01 * General psychopathology = 37.74 Based on meta-analytic results, an alternative five-factor solution of the PANSS was proposed with positive symptoms, negative symptoms, disorganization, excitement, and emotional distress.

References

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External links

The positive and negative syndrome scale (PANSS) for schizophrenia.The PANSS Institute
*https://www.webmd.com/schizophrenia/mental-health-schizophrenia#1 Schizophrenia Psychosis screening and assessment tools