Large-scale evaluation of the Positive and Negative Syndrome Scale (PANSS) symptom architecture in schizophrenia

Lim, Keane; Peh, Oon-Him; Yang, Zixu; Rekhi, Gurpreet; Rapisarda, Attilio; See, Yuen-Mei; Rashid, Nur Amirah Abdul; Ang, Mei-San; Lee, Sara-Ann; Sim, Kang; Huang, Hailiang; Lencz, Todd; Lee, Jimmy; Lam, Max

doi:10.1016/j.ajp.2021.102732

Cited by 39 publications

(17 citation statements)

References 86 publications

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“…There were no significant differences in the PANSS total scores in the REH and CON groups after the 3-month treatment ( Table 2 . However, based on the five PANSS factor models, some improvements were identified, almost exclusively in the REH group, in terms of: positive factor—Kay et al [ 38 ], Walsh et al [ 35 ], Lim et al [ 41 ], and Citrome et al [ 40 ]; depression/anxiety factor—Kay et al [ 39 ], Lim et al [ 41 ], and Citrome et al [ 40 ]; excitement/hostility factor—Kay et al [ 39 ]. Contrary to this, the CON group worsened in the excitement/hostility factor across nearly all models [ 39 , 40 , 41 ].…”

Section: Resultsmentioning

confidence: 99%

“… The male-specific model derived from the gender-specific PANSS-related trial (structure of PANSS separate for women and men); it consists of positive, negative, cognitive, and hostility factors [ 35 ]. Five-factor models: The largest multi-ethnic PANSS-related trial ( n = 3511), validated with the largest meta-analysis; the model of positive, negative, cognitive/disorganization, depression/anxiety, and hostility factors (PANSS factor structure from a large multi-ethnic sample) [ 41 ]. The largest pooled data pharmacological analysis, related methodologically to one single anti-psychotic ( n = 3580); the model of positive, negative, depression/anxiety, cognitive, and excitement/hostility factors (a 5-factor analysis to evaluate the efficacy of iloperidone compared to placebo) [ 40 ].…”

Section: Methodsmentioning

confidence: 99%

“…The largest multi-ethnic PANSS-related trial ( n = 3511), validated with the largest meta-analysis; the model of positive, negative, cognitive/disorganization, depression/anxiety, and hostility factors (PANSS factor structure from a large multi-ethnic sample) [ 41 ].…”

Section: Methodsmentioning

confidence: 99%

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Relationship of Neuropeptide S with Clinical and Metabolic Parameters of Patients during Rehabilitation Therapy for Schizophrenia

Markiewicz-Gospodarek

Dobrowolska

Maciejewski

et al. 2022

Brain Sciences

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Neuropeptide S (NPS) is a factor associated with the central regulation of body weight, stress, anxiety, learning, memory consolidation, wakefulness–sleep cycle, and anti-inflammatory and neuroplastic effects. Its stress-reducing, anti-anxiety, arousal without anxiety, and pro-cognitive effects represent an interesting option for the treatment of neuropsychiatric disorders. The purpose of the study was to examine the potential associations of NPS levels in the blood with clinical and metabolic parameters during the rehabilitation therapy of patients with schizophrenia. Thirty-three male subjects diagnosed with schizophrenia were randomly divided into two groups. The rehabilitation group (REH, N16) consisted of patients who were subjected to structured, 3-month intensive rehabilitation therapy, and the control group (CON, N17) consisted of patients who were subjected to a standard support mechanism. Both groups continued their pharmacological treatment as usual. The NPS concentration, as well as clinical and metabolic parameters, were compared in both groups. Additionally, a group of healthy (H) males (N15) was tested for NPS reference scores. To look for the specificity and selectivity of the NPS relationship with clinical results, various factor models of the positive and negative syndrome scale (PANSS) were analyzed, including the original PANSS 2/3 model, its modified four-factor version, the male-specific four-factor model, and two five-factorial models validated in large groups in clinical and multi-ethnic studies. Results and conclusions: (1) Structured rehabilitation therapy, compared to unstructured supportive therapy, significantly reduced the level of schizophrenia disorders defined by various factor models derived from PANSS. (2) The clinical improvement within the 3-month rehabilitation therapy course was correlated with a significant decrease in neuropeptide S (NPS) serum level. (3) The excitement/Hostility (E/H) factor, which included schizophrenic symptoms of the psychotic disorganization, was specific and selective for the reduction in serum NPS, which was stable across all analyzed factor models. (4) The long-term relationship between serum NPS and clinical factors was not accompanied by basic metabolic parameters.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Relationship of Neuropeptide S with Clinical and Metabolic Parameters of Patients during Rehabilitation Therapy for Schizophrenia

Markiewicz-Gospodarek

Dobrowolska

Maciejewski

et al. 2022

Brain Sciences

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“…Items are scored on a Likert scale from 1 (“Absent”) to 7 (“Extreme”), with higher scores indicating more severe symptoms. This study employed a pentagonal model of the PANSS, in accordance with factor analytic evidence ( Shafer and Dazzi, 2019 ; Lim et al, 2021 ). This is comprised of 5 factors: positive, negative, cognitive (measuring cognitive disorganization), affective (measuring anxiety and depression) and excitative (measuring activity and hostility); see Supplementary Table 1 .…”

Section: Methodsmentioning

confidence: 99%

“…Thus, this pathway may interact with a trauma pathway to psychosis. The positive/negative symptom solutions typically used in the scoring of the PANSS may not capture such cognitive difficulties; factor analytic studies have identified a more complex underlying structure to the PANSS comprising positive, negative, cognitive, affective and excitative symptoms ( Wallwork et al, 2012 ; Shafer and Dazzi, 2019 ; Lim et al, 2021 ). Therefore, it is possible that post-traumatic sequelae more complex than PTSD – i.e., cPTSD – may lead to nuanced psychotic symptoms, such as cognitive/excitative symptoms.…”

Section: Introductionmentioning

confidence: 99%

The Role and Clinical Correlates of Complex Post-traumatic Stress Disorder in People With Psychosis

et al. 2022

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Traumatic experiences and post-traumatic stress are highly prevalent in people with psychosis, increasing symptom burden, decreasing quality of life and moderating treatment response. A range of post-traumatic sequelae have been found to mediate the relationship between trauma and psychotic experiences, including the “traditional” symptoms of post-traumatic stress disorder (PTSD). The International Classification of Diseases-11th Edition recognizes a more complex post-traumatic presentation, complex PTSD (cPTSD), which captures both the characteristic symptoms of PTSD alongside more pervasive post-traumatic sequelae known as ‘disturbances in self-organization’ (DSOs). The prevalence and impact of cPTSD and DSOs in psychosis remains to be explored. In the first study of this kind, 144 participants with psychosis recruited from North West United Kingdom mental health services completed measures assessing trauma, PTSD and cPTSD symptoms and symptoms of psychosis. Forty-percent of the sample met criteria for cPTSD, compared to 10% who met diagnostic criteria for PTSD. PTSD and DSOs mediated the relationship between trauma and positive symptoms, controlling for dataset membership. Both PTSD and DSOs mediated the relationship between trauma and affective symptoms but did not explain a significant proportion of variance in negative symptoms. Cognitive and excitative symptoms of psychosis did not correlate with trauma, PTSD or DSO scores. These findings indicate the possible value of adjunct therapies to manage cPTSD symptoms in people with psychosis, pending replication in larger epidemiological samples and longitudinal studies.

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Understanding the Phenomenology of Schizotypy and Schizotypal Personality Disorder: An Application of the Integrative Model of Metacognition

Lysaker,

Wiesepape

2023

A Dimensional Approach to Schizotypy

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Large-scale evaluation of the Positive and Negative Syndrome Scale (PANSS) symptom architecture in schizophrenia

Cited by 39 publications

References 86 publications

Relationship of Neuropeptide S with Clinical and Metabolic Parameters of Patients during Rehabilitation Therapy for Schizophrenia

Relationship of Neuropeptide S with Clinical and Metabolic Parameters of Patients during Rehabilitation Therapy for Schizophrenia

The Role and Clinical Correlates of Complex Post-traumatic Stress Disorder in People With Psychosis

Understanding the Phenomenology of Schizotypy and Schizotypal Personality Disorder: An Application of the Integrative Model of Metacognition

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