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1.
Roberto Rodriguez-Jimenez Alexandra Bagney Laura Mezquita Isabel Martinez-Gras Eva-Maria Sanchez-Morla Natalia Mesa Manuel-Ignacio Ibañez Justo Diez-Martin Miguel-Angel Jimenez-Arriero Antonio Lobo Jose-Luis Santos Tomas Palomo 《Schizophrenia Research》2013,143(1):77-83
Different exploratory and confirmatory factorial analyses of the Positive and Negative Syndrome Scale (PANSS) have found a number of factors other than the original positive, negative, and general psychopathology. Based on a review of previous studies and using confirmatory factor analyses (CFA), Wallwork et al. (Schizophr Res 2012; 137: 246–250) have recently proposed a consensus five-factor structure of the PANSS. This solution includes a cognitive factor which could be a useful measure of cognition in schizophrenia. Our objectives were 1) to study the psychometric properties (factorial structure and reliability) of this consensus five-factor model of the PANSS, and 2) to study the relationship between executive performance assessed using the Wisconsin Card Sorting Test (WCST) and the proposed PANSS consensus cognitive factor (composed by items P2-N5-G11). This cross-sectional study included a final sample of 201 Spanish outpatients diagnosed with schizophrenia. For our first objective, CFA was performed and Cronbach's alphas of the five factors were calculated; for the second objective, sequential linear regression analyses were used. The results of the CFA showed acceptable fit indices (NNFI = 0.94, CFI = 0.95, RMSEA = 0.08). Cronbach's alphas of the five factors were adequate. Regression analyses showed that this five-factor model of the PANSS explained more of the WCST variance than the classical three-factor model. Moreover, higher cognitive factor scores were associated with worse WCST performance. These results supporting its factorial structure and reliability provide robustness to this consensus PANSS five-factor model, and indicate some usefulness of the cognitive factor in the clinical assessment of schizophrenic patients. 相似文献
2.
Wallwork RS Fortgang R Hashimoto R Weinberger DR Dickinson D 《Schizophrenia Research》2012,137(1-3):246-250
Although the developers of the Positive and Negative Syndrome Scale (PANSS) grouped items into three subscales, factor analyses indicate that a five-factor model better characterizes PANSS data. However, lack of consensus on which model to use limits the comparability of PANSS variables across studies. We counted "votes" from published factor analyses to derive consensus models. One of these combined superior fit in our Caucasian sample (n=458, CFI=.970), and in distinct Japanese sample (n=164, CFI=.964), relative to the original three-subscale model, with a sorting of items into factors that was highly consistent across the studies reviewed. 相似文献
3.
BackgroundThe Positive and Negative Syndrome Scale (PANSS) is widely used for clinical assessment of symptoms in schizophrenia. Instead of the traditional pyramidal model, recent literature supports the pentagonal model for the dimensionality of the PANSS.AimThe present study aimed to validate the consensus five-factor model of the PANSS and evaluate its convergent validity.MethodsParticipants were 146 Chinese chronic schizophrenic patients who completed diagnostic interviews and cognitive assessments. Exploratory structural equation modeling (ESEM) was performed to investigate the dimensionality of the PANSS. Covariates (age, sex, and education level) and concurrent outcomes (perceived stress, memory, daily living functions, and motor deficits) were added in the ESEM model.ResultsThe results supported the consensus 5-factor underlying structure, which comprised 20 items categorized into positive, negative, excitement, depression, and cognitive factors with acceptable reliability (α = .69–.85) and strong factor loadings (λ = .41–.93). The five factors, especially the cognitive factor, showed evident convergent validity with the covariates and concurrent outcomes.ConclusionThe results support the consensus five-factor structure of the PANSS as a robust measure of symptoms in schizophrenia. Future studies could explore the clinical and practical utility of the consensus five-factor model. 相似文献
4.
van der Gaag M Hoffman T Remijsen M Hijman R de Haan L van Meijel B van Harten PN Valmaggia L de Hert M Cuijpers A Wiersma D 《Schizophrenia Research》2006,85(1-3):280-287
OBJECTIVE: The lack of fit of 25 previously published five-factor models for the PANSS items, can be due to the statistics used. The purpose of this study was to use a 'new' statistical method to develop and confirm an improved five-factor model. The improved model is both complex and stable. Complex means that symptoms can have multiple factor loadings, because they have multiple causes, not because they are ill defined. Stable means that the complex structure is found repeatedly in validations. METHODS: A ten-fold cross-validation (10 CV) was applied on a large data set (N = 5769) to achieve an improved factor model for the PANSS items. The advantages of 10 CV are minimal effect of sample characteristics and the ability to investigate the stability of items loading on multiple factors. RESULTS: The results show that twenty-five items contributed to the same factor all ten validations with one item showing a consistent loading on two factors. Three items were contributing to the same factor nine out of ten validations, and two items were contributing to the same factor six to eight times. The resulting five-factor model covers all thirty items of the PANSS, subdivided in the factors: positive symptoms, negative symptoms, disorganization, excitement, and emotional distress. The five-factor model has a satisfactory goodness-of-fit (Comparative Fit Index = .905; Root Mean Square Error of Approximation = .052). CONCLUSIONS: The five-factor model developed in this study is an improvement above previously published models as it represents a complex factor model and is more stable. 相似文献
5.
van der Gaag M Cuijpers A Hoffman T Remijsen M Hijman R de Haan L van Meijel B van Harten PN Valmaggia L de Hert M Wiersma D 《Schizophrenia Research》2006,85(1-3):273-279
OBJECTIVE: The aim of this study was to test the goodness-of-fit of all previously published five-factor models of the Positive and Negative Syndrome Scale (PANSS). METHODS: We used confirmatory factor analysis (CFA) with a large data set (N = 5769). RESULTS: The different subsamples were tested for heterogeneity and were found to be homogeneous. This indicates that despite variability in age, sex, duration of illness, admission status, etc., in the different subsamples, the structure of symptoms is the same for all patients with schizophrenia. Although previous research has shown that a five-factor model fits the data better than models with three or four factors, no satisfactory fit for any of the 25 published five-factor models was found with CFA. CONCLUSIONS: Variability in age, sex, admission status and duration of illness has no substantial effect on the structure of symptoms in schizophrenia. The lack of fit can be caused by ill-defined items that aim to measure several properties in a single rating. Another explanation is that well-defined symptoms can have two or more causes. Then a double or triple loading item should not be discarded, but included because the complexity of symptoms in schizophrenia is represented by these multiple loadings. Such a complex model not only needs confirmation by CFA, but also has to be proven stable. A 10-fold cross-validation is suggested to develop a complex and stable model. 相似文献
6.
The main objective of the study was to verify the stability of the five-factor (negative. positive, excitation, depression and cognitive) structure of the Positive and Negative Syndrome Scale (PANSS). The psychometric properties (validity and reliability) of the forced five-factor structure of the PANSS were explored in two different populations of schizophrenic patients: one in relapse and the other in the chronic phase of the disease. Three hundred and forty-two schizophrenic patients according to DSM-III-R criteria were involved. One hundred and eighteen (34.5%) patients were in relapse, and 224 (65.5%) were in the chronic phase. The forced five-factor principal-component analysis explained 64.3% of the total variance in the relapse patients and 62.1% in the chronic patients. The order of the factors was reversed for the depression and excitation factors in chronic patients compared with patients in relapse. The internal consistency of this five-factor structure was good (Cronbach's alpha >0.70) in the relapse and chronic patients, except for the cognitive factor. In conclusion. five dimensions (negative, positive, excitation, depression and cognition) are necessary to account for the various clinical aspects of schizophrenia described by PANSS in relapse and chronic schizophrenic patients. 相似文献
7.
The Swedish version of the Positive and Negative Syndrome Scale for schizophrenia (PANSS) has been tested and construct validity, internal reliability and interrater reliability have been demonstrated to be quite satisfactory. However, the interrater reliability of the negative symptoms was unsatisfactory low. In this study, the Swedish version of the Structured Clinical Interview for the PANSS has been tested. The interrater reliability is increased as compared with the inter-rater reliability achieved by means of the PANSS. As concerns the positive scale, the intraclass coefficients increased to 0.98–0.99 with the SCID-PANSS. For the negative scale, the intraclass coefficients increased to 0.83–0.90 with the SCID-PANSS, and for the general scale the increase was to 0.95–0.98 with the SCID-PANSS. It was also demonstrated that the interrater reliability is higher for the positive and the negative factors derived from the PANSS than for the positive and the negative scales. 相似文献
8.
T d'Amato T Rochet J Dalery A Laurent J H Chauchat J L Terra M Marie-Cardine 《Psychiatry research》1992,44(1):55-62
The Positive and Negative Syndrome Scale (PANSS) was used to rate clinical symptoms in 42 inpatients with schizophrenia before they were examined by computed tomography. Significantly higher mean size of lateral and third ventricles, and higher mean cortical atrophy were found in schizophrenic patients compared with healthy control subjects. Ventricular enlargement and cortical atrophy were significantly related to low scores on the Composite subscale of the PANSS. Positive correlations were observed mainly with negative items such as blunted affect, emotional withdrawal, difficulties in abstract thinking, passive-apathetic social withdrawal, and lack of spontaneity of conversation. Additional positive correlations were observed with two items from the General Psychopathology subscale (mannerisms and disorientation). Inverse correlations were found with most positive items. These results suggest a relationship between brain structural abnormalities and the symptomatology of schizophrenia recorded with PANSS. 相似文献
9.
Lindenmayer JP Brown E Baker RW Schuh LM Shao L Tohen M Ahmed S Stauffer VL 《Schizophrenia Research》2004,68(2-3):331-337
BACKGROUND: We sought to develop and validate an excitement subscale from the Positive and Negative Syndrome Scale (PANSS) to allow the investigation of mania-like excitement symptoms in clinical trials of patients with schizophrenia using the PANSS and to provide clinicians with a short assessment tool for these states. METHODS: Baseline PANSS data from six double-blind, randomized registration trials of olanzapine, three in schizophrenia and three in acute bipolar mania, were used in these post-hoc analyses. Schizophrenia study data were pooled and randomly split in half. Exploratory principal component factor analysis was performed on half of the data. Factors were extracted based on minimum eigenvalue criteria (eigenvalue> or =1); loadings were determined using an equamax rotation. Confirmatory principal component factor analysis was performed on the other half of the data, retaining the original number of factors. Principal component factor analysis was also done for the pooled bipolar studies. Change in the new mania-like factor scores was then correlated with Young Mania Rating Scale (Y-MRS) scores in each bipolar study. RESULTS: Exploratory principal components analysis on the pooled schizophrenia data extracted five factors: negative, positive, excitement, cognitive, and depressive factors. The mania-like excitement factor was represented by four items (uncooperativeness, poor impulse control, excitement, and hostility), with only moderate loadings by tension and suspiciousness/persecution. Results were similar in the confirmatory analysis and the pooled bipolar studies. Change from baseline to endpoint for the mania-like factor correlated reasonably well (0.64-0.78) with change in Y-MRS scores in the bipolar studies. At baseline, bipolar patients scored higher than patients with schizophrenia on three of four PANSS mania-like factor items: poor impulse control, excitement, and hostility; the converse was true for most other PANSS items. CONCLUSION: Factor analyses of the PANSS consistently uncovered an excitement factor including uncooperativeness, poor impulse control, excitement, and hostility items. This factor may be useful in examining manic symptoms in studies where the addition of a scale specific to mania would be burdensome and where symptoms of excitement are part of the clinical presentation. 相似文献
10.
The Positive and Negative Syndrome Scale (PANSS) has been translated into Swedish and tested in 88 chronic schizophrenic patients. All 4 subscales exhibited a roughly normal distribution. The overall alpha for the positive, negative and general psychopathology subscales were 0.81, 0.58 and 0.63, respectively. The correlation between the positive and negative subscales was -0.17 (NS). The interrater reliability was 0.73-0.75 for the positive, 0.65-0.74 for the negative and 0.75-0.77 for the general psychopathology subscales. The intraclass coefficients were 0.75-0.77 for the positive, 0.27-0.46 for the negative, 0.56-0.72 for the general psychopathology subscales and 0.66-0.71 for the total scale. Thus, the validity and reliability of the PANSS (Swedish version) are quite satisfactory. 相似文献
11.
Emsley R Rabinowitz J Torreman M;RIS-INT- Early Psychosis Global Working Group 《Schizophrenia Research》2003,61(1):47-57
The Positive and Negative Syndrome Scale (PANSS) is a widely used instrument for measuring severe psychopathology in adult patients with schizophrenia. Data, primarily on chronic patients, have been used to define factors for the PANSS. The present study examines the PANSS factor structure in a large sample of subjects with recent-onset schizophrenia, schizophreniform disorder and schizoaffective disorder who had been exposed to very limited antipsychotic medication. Equamax factor analysis was conducted on PANSS baseline assessments from a multicenter, 11 country drug trial that enrolled 535 patients. The forced five-factor solution essentially corresponds to the factors most frequently described previously, namely negative, positive, disorganized (or cognitive), excited and anxiety/depression. In the exploratory analysis, a seven-factor solution was obtained, with depression and anxiety symptoms separating and a motor component emerging. The results of this study partially support the use of a five-factor model for the PANSS, but suggest that scales for catatonia, depressive and anxiety syndromes should be included in future studies. 相似文献
12.
Todd S. Woodward Kwanghee Jung Geoffrey N. Smith Heungsun Hwang Alasdair M. Barr Ric M. Procyshyn Sean W. Flynn Mark van der Gaag William G. Honer 《European archives of psychiatry and clinical neuroscience》2014,264(8):673-682
Refractory psychosis units currently have little information regarding which symptoms profiles should be expected to respond to treatment. In the current study, we provide this information using structural equation modeling of Positive and Negative Syndrome Scale (PANSS) ratings at admission and discharge on a sample of 610 patients admitted to a treatment refractory psychosis program at a Canadian tertiary care unit between 1990 and 2011. The hypothesized five-dimensional structure of the PANSS fit the data well at both admission and discharge, and the latent variable scores are reported as a function of symptom dimension and diagnostic category. The results suggest that, overall, positive symptoms (POS) responded to treatment better than all other symptoms dimensions, but for the schizoaffective and bipolar groups, greater response on POS was observed relative to the schizophrenia and major depression groups. The major depression group showed the most improvement on negative symptoms and emotional distress, and the bipolar group showed the most improvement on disorganization. Schizophrenia was distinct from schizoaffective disorder in showing reduced treatment response on all symptom dimensions. These results can assist refractory psychosis units by providing information on how PANSS symptom dimensions respond to treatment and how this depends on diagnostic category. 相似文献
13.
The present study focuses on schizophrenia patient subgroups with specific symptom pattern using the Positive and Negative Syndrome Scale (PANSS). In this report, we intend to (1) provide a more appropriate analytic method for exploring the subgroups based on PANSS data, (2) validate identified subgroups with external variables, and (3) estimate probabilities of subgroup changes between 2 disease states. The analyzed data include 219 acute-state patients who had completed the PANSS within 1 week of index admission and 225 subsided-state patients who were living in the community and under family care. Regression extension of latent class analysis was performed. We found that acute schizophrenia can be classified into 4 subgroups—whole syndrome, whole syndrome without hostility, partial syndrome with negative symptoms, and partial syndrome with pure reality distortion—and that subsided schizophrenia can be classified into 3 subgroups—florid symptom, marked negative, and remitted. Patients of the whole syndrome, whole syndrome without hostility, partial syndrome with negative symptoms, and partial syndrome with pure reality distortion subgroups at the acute state were most likely to transit to the florid symptom (61%), florid symptom (48%), marked negative (42%), and remitted (56%) subgroups at the subsided state, respectively. Significant relationships of obtained subgroups with sociodemographic variables and neurocognitive variables were identified. These results of different subgroups will provide the background for facilitating current molecular, genetic, and neurobiological studies of schizophrenia. 相似文献
14.
Jan Stochl Peter B. Jones James Plaistow Ulrich Reininghaus Stefan Priebe Jesus Perez Tim J. Croudace 《International journal of methods in psychiatric research》2014,23(1):25-35
Clinical assessments of the presence and severity of psychopathology are often collected by health care professionals in mental health services or clinical researchers trained to use semi‐structured interviews. Clustering by interviewer or rater needs to be considered when performing psychometric analyses such as factor analysis or item response modelling as non‐independence of observations arises in these situations. We apply more suitable multilevel methods to analyse ordinally scored Positive and Negative Syndrome Scale (PANSS) items. Our aim is to highlight the differences in results that occur when the data are analysed using a hierarchically sensitive approach rather than using a traditional (aggregated) analysis. Our sample (n = 507) consisted of patients diagnosed with schizophrenia who participated in a multi‐centre randomized control clinical trial, the DIALOG study. Analyses reported and compared include an exploratory factor analysis as well as several recently published multifactor models re‐estimated within a confirmatory analysis framework. Our results show that the fit of the model and the parsimony of the exploratory factor analysis (EFA) models indicated by the number of factors necessary to explain the inter‐correlation among PANSS items improved significantly when data clustering is taken into account through multilevel analysis. Our modeling results support the pentagonal PANSS model first proposed by White et al. (1997). Copyright © 2014 John Wiley & Sons, Ltd. 相似文献
15.
16.
S R Kay A Fiszbein M Vital-Herne L S Fuentes 《The Journal of nervous and mental disease》1990,178(8):510-517
The Positive and Negative Syndrome Scale (PANSS) consists of a formalized clinical interview and 30 operationally defined items for psychopathology assessment. We report here on the psychometric equivalence of a Spanish language adaptation (PANSS-S), developed to facilitate minority group, multinational, and cross-cultural studies on schizophrenia. Two bilingual psychiatrists simultaneously rated 57 psychiatric inpatients using the PANSS (N = 20), PANSS-S (N = 20), or both methods (N = 17). The PANSS-S demonstrated sound interrater reliabilities (r = .93 for positive and .74 for negative syndrome, p less than .001), which were similar to those from the current PANSS assessment and original standardization studies. In support of criterion-related validity, the means and variance of the two instruments were comparable, and significant cross-correlations were obtained for the principal scales (r = .92 for positive and .83 for negative syndrome, p less than .0001), component symptoms, and five additional psychopathology clusters. The results suggest that the PANSS-S has psychometric properties resembling those of the PANSS and may be used interchangeably in a Spanish-speaking population. 相似文献
17.
Rossi A Daneluzzo E Arduini L Di Domenico M Stratta P Petruzzi C 《European archives of psychiatry and clinical neuroscience》2000,250(5):254-256
To investigate the clinical specificity of mixed affective patients, we compared the clinical characteristics of pure manic
patients with those of mixed manic patients. The clinical symptoms of 146 bipolar inpatients hospitalized for a manic episode
were assessed by means of the Positive and Negative Syndrome Scale. Mixed patients showed more positive and cognitive symptoms
and among these the lack of judgement and insight was prominent. Further studies are needed to clarify the specificity of
lack of insight of the mixed bipolar patients.
Received: 28 January 2000 / Accepted: 31 May 2000 相似文献
18.
19.
OBJECTIVE: The main objective of this study was to evaluate the psychometric properties of the French-language version of the Positive and Negative Syndrome Scale (PANSS). METHOD: The validity and reliability of the PANSS were studied in a population of 342 patients diagnosed as schizophrenic according to DSM-III-R criteria. RESULTS: The study of the internal consistency and principal-component analysis of the initial structure with three subscales (positive, negative and general psychopathology) led us to investigate other factorial structures. We isolated a 5-factor structure (negative, positive, hostility, disorganization and anxiety/depression) explaining 57.5% of the total variance. The internal consistency of the 5 factors isolated was good (0.87 for the negative factor, 0.82 for the positive factor, 0.78 for the hostility factor, 0.71 for the disorganization factor and 0.68 for the anxiety/depression factor, respectively). The validity study on the external criteria confirmed the relationship between the negative and anxiety/depression factors and the extrapyramidal symptoms. CONCLUSION: The stability of the PANSS factorial warrants discussion. 相似文献
20.
Rzewuska M 《International journal of methods in psychiatric research》2002,11(1):27-32
This study presents the results of a training course on using the Positive and Negative Syndrome Scale (PANSS) for the assessment of mental status. The agreements between ratings produced by 418 physicians (psychiatrists) were evaluated and compared with standard ratings. In this way it was possible to supplement some of the listed symptoms with comments, which may help to increase agreement between results obtained through raters' assessments and standard ratings. 相似文献