Clinical validation of ratings on the six-item Positive and Negative Syndrome Scale obtained via the Simplified Negative and Positive Symptoms Interview

Abstract

Background: The six-item version of the Positive and Negative Syndrome Scale (PANSS-6) has shown promise as a brief measure of the severity of core symptoms of schizophrenia. However, since all prior analyses of the PANSS-6 were based on data extracted from studies using the full 30-item PANSS (PANSS-30), it remains unknown whether it is possible to obtain valid information for the PANSS-6 ratings via a brief interview, such as the Simplified Negative and Positive Symptoms Interview (SNAPSI). Aims: We aimed to validate the PANSS-6 ratings obtained via the SNAPSI using the PANSS-6 scores extracted from the PANSS-30 ratings obtained via the comprehensive Structured Clinical Interview for PANSS (SCI-PANSS) as the gold-standard reference. Methods: The PANSS-6 ratings based on the SNAPSI and the PANSS-30 ratings based on the SCI-PANSS were conducted by independent raters with established inter-rater reliability. Results: Seventy-seven inpatients with schizophrenia ( Mage = 35.1 ± 11.7 years; males = 57%; paranoid schizophrenia = 75%) participated in the study. The intraclass correlation coefficient (ICC) of the PANSS-6 total scores obtained using the SNAPSI and the PANSS-30-derived PANSS-6 total scores via the SCI-PANSS was 0.77 ( p < 0.001). The ICC for the PANSS-6 total score and the PANSS-30-derived PANSS-8 (Andreasen’s remission criteria) was 0.75 ( p < 0.001). Spearman’s rank correlation coefficient for changes in PANSS-6 total scores via the SNAPSI and changes in PANSS-30-derived PANSS-6 total scores was 0.70 ( p < 0.001). Conclusions: Using the SNAPSI to rate the PANSS-6 enables a focused and brief assessment of the severity of core symptoms of schizophrenia, which facilitates measurement-based care and clinical decision making in the treatment of schizophrenia.

A Guideline and Checklist for Initiating and Managing Clozapine Treatment in Patients with Treatment-Resistant Schizophrenia

“…Where possible, use a standardized symptom-rating scale, such as the 30-item Positive and Negative Symptom Scale (PANSS) [ 91 ], or a standardized brief psychiatric rating scale, such as the six-item PANSS-6 [ 92 – 95 ] (Table 3 ) at baseline and subsequently to determine responses to therapy.…”

Measurement-Based Care for Psychotic Disorders in the Veterans Health Administration

“…26,35,36 Despite the benefits of MBC and the fact that providers view it favorably, 37 it has not been widely adopted. 2,7,38 Beyond the obstacles that impede the adoption of MBC generally, 7,8,39 implementing MBC for psychotic disorders is further complicated by a lack of well-established recommendations for psychosis-specific PROMs, 25,40 challenges in using selfreport measures, 41 and a lack of research on measures of functioning or quality of life specifically as part of MBC for psychotic disorders. When research is limited, current clinical practices can be informative.…”

Validation of ratings on the six-item Positive and Negative Syndrome Scale obtained via the Simplified Negative and Positive Symptoms Interview among outpatients with schizophrenia

“…PANSS-30 ratings were conducted following administration of the SCI-PANSS supported by the Informant Questionnaire for the PANSS (IQ-PANSS; Kay et al, 2006). The SCI-PANSS is a semi-structured clinical interview, which takes approximately 45-60 min to conduct (Kay et al, 1992;Kølbaek et al, 2021), while the IQ-PANSS consists of questions relating to 14 of the PANSS items and is completed by an informant.…”

“…To reduce the time required for conducting PANSS-6 ratings, a brief semi-structured interview has been developed, the Simplified Negative and Positive Symptoms Interview (SNAPSI), which takes approximately 15-20 min to administer (Østergaard et al, 2017). A recent study among inpatients examined the clinical validity of the PANSS-6+SNAPSI combination (Kølbaek et al, 2021), using the PANSS-30 (Kay et al, 1987) with the Structured Clinical Interview for the Positive and Negative Syndrome Scale (SCI-PANSS; Kay et al, 1992) as the gold standard reference. Specifically, an intra-class coefficient (ICC) of 0.77 [95% confidence interval (CI) = 0.62-0.85] was observed in this study-indicating an excellent level of agreement (Cicchetti, 1994)-between the PANSS-6 SNAPSI and the PANSS-6 SCI-PANSS total scores.…”