An excitement subscale of the Positive and Negative Syndrome Scale

Lindenmayer, Jean-Pierre; Brown, Eileen; Baker, Robert W.; Schuh, Leslie M.; Shao, Lixin; Tohen, Mauricio; Ahmed, Saeeduddin; Stauffer, Virginia L.

doi:10.1016/s0920-9964(03)00087-2

Cited by 103 publications

(61 citation statements)

References 19 publications

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“…These are not unlike those observed in studies of patients with schizophrenia [9][10][11][14][15][16][17] . One notable difference is that the factor with the highest variance was anxiety in patients with bipolar mania in the present study while it is the negative factor in the studies of patients with schizophrenia.…”

Section: Discussioncontrasting

confidence: 72%

“…These were identified as positive, negative, and mixed depressive-activated factors in the mania patients and positive, negative, and depressive factors in the schizophrenia patients, again supporting a dimensional continuum between the two disorders. In a recent study of 1,289 patients with schizophrenia and 504 patients with bipolar mania, Lindenmayer et al [11] extracted an excitement component in the two groups of patients. The same four items (uncooperativeness, poor impulse control, excitement, and hostility) had factor loadings 1 0.5 on the excitement factor in both patients with schizophrenia and mania as seen in the manic patients of the present study.…”

Section: Discussionmentioning

confidence: 99%

“…In 1986, Crow [8] proposed that 'psychosis is a continuum extending from unipolar through bipolar affective illness and schizoaffective psychosis to typical schizophrenia, with increasing degrees of defect'. Thus, it is of interest to determine whether dimensions of psychosis in bipolar patients can be identified that are similar to those observed in patients with schizophrenia [9][10][11] .…”

Section: Introductionmentioning

confidence: 99%

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Dimensions of Psychosis in Patients with Bipolar Mania as Measured by the Positive and Negative Syndrome Scale

et al. 2008

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Background: Psychosis is present in 50% or more of patients with bipolar mania and is commonly evaluated in clinical research by means of the Positive and Negative Syndrome Scale (PANSS). The aim of the present analysis was to investigate the psychotic dimensions of bipolar disorder and its contributing symptoms based on a factor analysis of baseline PANSS scores and to compare them with those identified in studies of patients with schizophrenia and bipolar disorder. Sampling and Methods: Baseline data were analyzed from two 3-week, double-blind, placebo-controlled studies of risperidone monotherapy for acute mania associated with bipolar I disorder (n = 535). Inclusion criteria were a DSM-IV diagnosis of bipolar I disorder with manic features, with or without psychotic features, age ≧18 years, and mean baseline Young Mania Rating Scale scores ≧20. A principal component analysis of the 30 PANSS item scores of the 535 patients with a diagnosis of a manic episode at baseline was conducted. Results: Five factors were extracted by the analysis: anxiety (13.4% of the variance), negative symptoms (12.3%), depression (10.5%), excitement (10.3%), and positive symptoms (8.7%). Similar factors, in particular the negative, excitement, and positive factors, have been identified in patients with schizophrenia. There was an absence of a cognitive factor supporting the notion that bipolar patients may present fewer cognitive symptoms. Conclusion: The results of the present analysis and those of other studies indicate similarities in psychotic symptom domains, as measured by the PANSS, in patients with bipolar mania and schizophrenia. Future analyses will address the effects of treatment on the identified factors.

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Section: Discussioncontrasting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dimensions of Psychosis in Patients with Bipolar Mania as Measured by the Positive and Negative Syndrome Scale

et al. 2008

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“…To assess manic symptoms, from the PANSS, we extracted a four item "Excitement" subscale (grandiosity, impulsiveness, hostility, and excitability), which has been previously shown to correspond to established measure of manic symptoms (18). The research assistants who administered and scored these scales were kept unaware of the participant's diagnostic status (to the extent possible) and DRS performance during administration and scoring.…”

Section: Clinical Evaluationmentioning

confidence: 99%

Assessment of Medication Management Ability in Middle-Aged and Older Adults With Bipolar Disorder

Depp

Cain²,

Palmer³

et al. 2008

Journal of Clinical Psychopharmacology

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Medication non-adherence is a key clinical concern in bipolar disorder across the lifespan. Cognitive deficits in older adults with bipolar disorder may hinder medication management ability, which, in turn, may lead to non-adherence. Using an innovative performance-based measure of medication management ability, the Medication Management Ability Assessment (MMAA), we compared performance of 29 middle-aged older community dwelling outpatients with bipolar disorder who were clinically stable (mean age=61, sd=11 years; rage 45 to 86) to 59 normal control subjects (NCs) and 219 outpatients with schizophrenia. The MMAA is a role-play task that simulates a medication regimen likely to be encountered by older adults. Within the bipolar group, we examined the relationships of MMAA scores to demographic, psychiatric symptoms severity, and the Dementia Rating Scale scores. The bipolar group made 2.8 times the errors on the MMAA than NCs (Bipolar group =6.2 (sd=5.5) vs. NCs=2.2 (sd=2.5), and did not significantly differ from the schizophrenia group in errors on the MMAA. Errors in the bipolar group were more likely to be in taking too few medications as in taking too many. Within the bipolar group, a significant correlation was seen between MMAA scores and DRS Total Score, but not with age, education, BPRS, HAM-D, number of psychiatric medications, or medical conditions. Among DRS subscales, the Memory Subscale correlated most strongly with MMAA errors. This small cross-sectional study suggests that deficits in medication management ability may be present in later-life bipolar disorder. Neurocognitive deficits may be important in understanding problems with unintentional non-adherence.

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“…Although the PANSS has been specifically developed for schizophrenic disorders, its 'general psychopathology' subscale allows a significant number of symptoms not specific to schizophrenic disorders to be rated as well. To date, however, only few studies have compared patients with acute schizophrenic and bipolar disorders, finding more similarities than differences with the exception of cognitive [25] and excitement [26] factors. It must be emphasized that none of the PANSS studies cited are based on relatives' ratings.…”

Section: Introductionmentioning

confidence: 99%

Standardized Assessment of Psychopathology by Relatives of Mentally Disordered Patients

Nitsche¹,

Kallert²

2007

Psychopathology

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Background: For optimizing the validity of diagnoses of mental disorders, several sources of information should be used to assess psychopathological symptoms. Among these are relatives of patients with mental illness. The very low number of empirical studies examining the assessment of psychopathology by relatives of adult, nondemented mentally ill patients stands in significant contrast to the clinical importance of this source of information, however. Sampling and Methods: Using the Positive and Negative Syndrome Scale (PANSS), researchers asked 163 relatives of patients with the main clinical ICD-10 diagnosis of schizophrenic, recurrent depressive or bipolar disorders to rate the current symptoms of the patients at the time of outpatient community-oriented treatment. Results: On average, severity of symptoms was rated as absent or minimal, although anxiety, depression and passive/apathetic social as well as emotional withdrawal, motor retardation, poor attention, and disturbance of volition were clearly rated above the PANSS mean total score for all patients. A six-factor structure identified by factor analysis better illustrates the significant differences in the assessments of the three main diagnostic groups than the three established PANSS scales. With the exception of ‘problematic social behavior’, differences among the diagnostic groups appeared in all factors and were particularly pronounced for ‘delusional beliefs’ and ‘motor impairments’. Conclusions: The results of this study showed that the use of standardized instruments such as PANSS for the assessment of psychopathology by relatives is not only practical, but produces adequately reliable results. The use of PANSS for this purpose, however, requires interviewing of relatives by trained experts able to explain technical terms. Because this study did not sufficiently explore the validity of this approach, further research on this specific issue is urgently needed and should, for example, assess the concordance of ratings between professionals and relatives as well as correlation with suitable external criteria.

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An excitement subscale of the Positive and Negative Syndrome Scale

Cited by 103 publications

References 19 publications

Dimensions of Psychosis in Patients with Bipolar Mania as Measured by the Positive and Negative Syndrome Scale

Dimensions of Psychosis in Patients with Bipolar Mania as Measured by the Positive and Negative Syndrome Scale

Assessment of Medication Management Ability in Middle-Aged and Older Adults With Bipolar Disorder

Standardized Assessment of Psychopathology by Relatives of Mentally Disordered Patients

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