Recommendations to improve the Positive and Negative Syndrome Scale (PANSS) based on item response theory

Stephen Z. Levine, Jonathan Rabinowitz, Dimitris Rizopoulos

Research output: Contribution to journalArticlepeer-review

40 Scopus citations

Abstract

The adequacy of the Positive and Negative Syndrome Scale (PANSS) items in measuring symptom severity in schizophrenia was examined using Item Response Theory (IRT). Baseline PANSS assessments were analyzed from two multi-center clinical trials of antipsychotic medication in chronic schizophrenia (n = 1872). Generally, the results showed that the PANSS (a) item ratings discriminated symptom severity best for the negative symptoms; (b) has an excess of "Severe" and "Extremely severe" rating options; and (c) assessments are more reliable at medium than very low or high levels of symptom severity. Analysis also showed that the detection of statistically and non-statistically significant differences in treatment were highly similar for the original and IRT-modified PANSS. In clinical trials of chronic schizophrenia, the PANSS appears to require the following modifications: fewer rating options, adjustment of 'Lack of judgment and insight', and improved severe symptom assessment.

Original languageEnglish
Pages (from-to)446-452
Number of pages7
JournalPsychiatry Research
Volume188
Issue number3
DOIs
StatePublished - 15 Aug 2011

Keywords

  • Item Response Theory
  • PANSS
  • Psychometrics
  • Schizophrenia
  • Severity of Illness Index

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