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Schizophrenia Bulletin
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Schizophrenia Bulletin
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M35. CLINICAL VALIDATION OF THE SIX-ITEM POSITIVE AND NEGATIVE SYNDROME SCALE (PANSS-6)

Authors: Kølbæk, Pernille; Dines, David; Holm, Tine; Blicher, Anne B; Sørensen, Rune D; O’Leary, Kathrine M; Feller, Sandra G; +6 Authors

M35. CLINICAL VALIDATION OF THE SIX-ITEM POSITIVE AND NEGATIVE SYNDROME SCALE (PANSS-6)

Abstract

Abstract Background The development of the brief and psychometrically valid, six-item Positive and Negative Syndrome Scale (PANSS-6) holds promise to improve the treatment of schizophrenia by paving the way for implementation of measurement-based care. However, an important limitation to the existing studies of PANSS-6 is that PANSS-6 was extracted from studies in which the 30-item PANSS ratings were obtained through the Structured Clinical Interview (SCI-PANSS). Therefore, it remains unknown whether it is possible to extract sufficient and equally valid information for PANSS-6 rating via a brief and focused interview, which is a prerequisite for the utility of PANSS-6 in clinical practise. The Simplified Negative And Positive Symptoms Interview (SNAPSI) is a brief semi-structured interview, which focuses specifically on extracting information on the PANSS-6. The aim of the present study was to perform a clinical validation study of PANSS-6 ratings obtained via the SNAPSI using PANSS-30 ratings obtained via SCI-PANSS as a gold standard reference. Methods Participants were ≥18 years old, had a diagnosis of schizophrenia (ICD-10: F20.x) and were undergoing inpatient treatment at the Department for Psychosis, Aarhus University Hospital - Psychiatry, Denmark. The SNAPSI and the SCI-PANSS were conducted by trained and reliable independent interviewers, which was followed by independent PANSS-6 and PANSS-30 ratings at two time-points: as soon as possible after admission and as close to discharge as possible. The degree to which the PANSS-6 (rated independently using the SNAPSI) corresponds to PANSS-6 extracted from PANSS-30 (rated using the SCI-PANSS) was tested by means of intra-class correlation coefficient (ICC) analysis. The sensitivity to change was tested by comparing the endpoint-baseline change in the PANSS-6 total scores to the endpoint-baseline change in the PANSS-6 total scores extracted from the PANSS-30 ratings via Spearman correlation analysis. Results A total of 77 inpatients with schizophrenia (age=35.3, SD=11.8 years; males=56%, paranoid schizophrenia=79%) were included. Of these 65% (n=50) were rated at two time-points. Time to complete the SNAPSI was 18.1, SD=6.9 minutes. The mean score of PANSS-30 at baseline and at follow-up was 81.0, SD=15.9 and 71.8, SD=12.5, respectively. The mean score of PANSS-6 at baseline and follow-up was 18.8, SD=4.6 and 18.1, SD=4.0, respectively. The ICC between the PANSS-6 total scores obtained by the SNAPSI and the PANSS-6 total scores extracted from the PANSS-30 ratings was 0.77 [95% CI 0.62–0.85]. The absolute mean deviation between PANSS-6 ratings and PANSS-6 derived from PANSS-30 ratings was 0.7, SD=0.9. Three percent (n=4) of the PANSS-6 ratings deviated by more than a mean of 1 point i.e. >6 points on the PANSS-6 total score compared to the PANSS-6 derived from PANSS-30 ratings. The Spearman correlation coefficient for changes in endpoint-baseline PANSS-6 and PANSS-30 derived PANSS-6 total scores was 0.67, p<0.001. The full results of the study will be presented at the SIRS 2020 conference. Discussion We found an excellent level of correlation between the PANSS-6 total scores obtained via SNAPSI and the PANSS-6 total scores extracted from the PANSS-30 ratings obtained via SCI-PANSS. Also, the sensitivity to change reached a good level of agreement. In conclusion, the combination of SNAPSI and PANSS-6 allows for a brief and valid assessment of the severity of core symptoms of schizophrenia. These results hold promise for the implementation of measurement-based care in the treatment of schizophrenia.

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
2
Average
Average
Average
Green
hybrid