X-ray computed tomographic abnormalities in schizophrenia. Trial of relationship with clinical data]

Computerized tomography (CT-scan) studies in schizophrenia revealed that some patients have neuromorphological abnormalities. The structural changes consist mainly in lateral and third ventricle enlargement, and in cortical atrophy. The present study evaluates these three changes in 42 schizophrenics aged 18 to 50, compared to 24 healthy controls. Diagnosis were established from information gathered by personal interview with the SADS-LA. Clinical sub-types were evaluated according to the DSM III-R criteria. Moreover, detailed symptoms were rated according to the Positive And Negative Syndrome Scale (PANSS). CT scans were recorded in floppy disks and blindly analyzed. Schizophrenics shown significant higher mean size of lateral and third ventricles, and higher mean anterior cortical atrophy than healthy subjects. Significant differences were also found between subtypes, with more marked abnormalities in the disorganized group. The relationship between brain abnormalities and clinical symptoms recorded with the PANSS, were analysed using Pearson correlates. Positive correlations concerned mainly negative symptoms like blunted affect, emotional withdrawal, difficulties in abstract thinking, passive apathetic social withdrawal and lack of spontaneity of conversation. Positive correlations are also observed with some symptoms classified with the PANSS in the General Psychopathology scale such as mannerism and disorientation. Negative correlation concerned most of PANSS positive symptoms.     

Aggression and psychopathology in treatment-resistant inpatients with schizophrenia and schizoaffective disorder

Positive psychotic symptoms, such as threat/"control-override" delusions or command hallucinations, have been related to aggression in patients with schizophrenia. However, retrospective data collection has hampered evaluation of the direct influence of psychopathology on aggressive behavior. In this study, we monitored aggressive behavior and psychopathology prospectively and in close temporal proximity in 157 treatment-resistant inpatients diagnosed with chronic schizophrenia or schizoaffective disorder participating in a 14-week double-blind clinical trial. Aggressive behavior was rated with the overt aggression scale (OAS). Psychopathology was assessed using the positive and negative syndrome scale (PANSS). At baseline, subjects who would be aggressive during the study had higher scores on only two PANSS items: hostility and poor impulse control. During the study PANSS positive subscale scores were significantly higher in aggressive subjects. Total PANSS scores were higher within 3 days of an aggressive incident, as were positive and general psychopathology subscale scores. However, in a smaller subsample for whom PANSS ratings were available within 3 days before aggressive incidents, only scores on the PANSS positive subscale were significantly higher. These findings in chronic, treatment resistant inpatients support the view that positive symptoms may lead to aggression.     

吸烟对精神分裂症男性患者精神病理症状的影响

目的 分析吸烟对精神分裂症临床精神病理症状的影响,探索精神分裂症患者高比例吸烟的原因.方法 收集慢性精神分裂症吸烟患者(332例)和非吸烟患者(95例)共427例,首次发病(以下简称首发)精神分裂症吸烟患者(22例)和非吸烟患者(41例)共63例,均为男性;使用阳性和阴性症状最表(PANSS)评定其临床精神病理症状.结果 (1)在慢性精神分裂症患者巾,吸烟组PANSS阴性症状分量表中的情感交流障碍得分[(3.9±1.5)分]、被动或淡漠得分[(3.6±1.6)分]及其总分[(24.0.±8.2)分]低于非吸烟组[分别为(4.4.±1.7)分、(4.0±1.7)分和(26.3.±9.5)分;P<0.05];PANSS阴性症状分量表7个条目得分及其总分、一般精神病理分量表总分和PANSS总分与患者每天的吸烟量呈负相关(P<0.05～0.01);阴性症状分量表中的情感交流障碍[比值比(OR)=0.832,95%可信区间(95%CI)=0.691～0.980,P=0.029]和一般精神病理分量表中的紧张(OR=0.534,95%CI=0.363～0.786,P=0.001)进入Logistic模型.(2)在首发精神分裂症患者中,吸烟组在阴性症状分量表中的情绪退缩得分[(2.7±1.3)分]、被动或淡漠得分[(2.7 ±1.3)分]低于非吸烟组[分别为(3.5±1.3)分和(3.5±1.4)分;P<0.05];一般精神病理分量表中的动作迟缓与患者每天的吸烟量呈负相关,自知力缺乏与吸烟量呈正相关(均P<0.05);PANSS一般精神病理分量表中的动作迟缓(OR=0.589,95%CI:0.350～0.989,P=0.045)进入Logistic模型.结论 吸烟对阴性症状的正性作用可能是精神分裂症患者高比例吸烟的原因之一.     

Apathy in schizophrenia: clinical correlates and association with functional outcome

Apathy is considered one of the negative symptoms of schizophrenia, but its natural history and relationship to other clinical characteristics have not been systematically studied. The purpose of this cross-sectional study was to measure the level of apathy in schizophrenia and its relation to other symptoms and functional outcome. Twenty-eight patients with schizophrenia, and receiving antipsychotic treatment, were assessed with the Apathy Evaluation Scale (AES). The mean level of apathy of patients with schizophrenia, as rated by the AES, was significantly higher than that of matched healthy control subjects. In the patients, apathy was not significantly correlated with positive symptoms or depressive symptoms. It was significantly correlated with the item "emotional withdrawal" on the negative subscale of the Positive and Negative Syndrome Scale (PANSS), but was not correlated with the overall negative subscale score. Apathy was more highly associated with functional outcome than were other symptom measures, and it was independently associated with functional outcome above and beyond other negative symptoms. It was not associated with observed interest in playing a video game or performance on a simulated clerical task.     

The Positive and Negative Syndrome Scale and the Brief Psychiatric Rating Scale. Reliability, comparability, and predictive validity.

In a psychiatric rehabilitation study, 154 concurrent ratings were performed using the 30-item Positive and Negative Syndrome Scale (PANSS) and the 18-item Brief Psychiatric Rating Scale (BPRS). Although both instruments had excellent interrater reliability, the PANSS was consistently better: on the 18 symptom items the two instruments share, the PANSS had higher intraclass r's on 14; for the syndromes, the PANSS was higher than the BPRS on positive, negative, and total. Weighted Kappas comparing shared items revealed that most were not interchangeable, with only three coefficients in the excellent range. However, syndrome scale scores were very highly correlated and resulted in similar classification for negative schizophrenia. Ten of the 12 items of the PANSS not included in the BPRS had low zero-order correlations with BPRS items, which suggests that they measure symptoms distinct from those measured by the BPRS and should add to clinical predictive power. This proved true in our study of rehabilitation of patients with schizophrenia. PANSS symptom ratings explained up to 55% of the variance on seven measures of work performance, whereas the BPRS had lower predictive power on six of the seven measures. We concluded that the PANSS may be superior to the BPRS in clinical research on schizophrenia and that most BPRS items are not interchangeable with identically named PANSS items.     

Cross-cultural adaptation and validation of the Spanish version of the Calgary Depression Scale for Schizophrenia

BACKGROUND: The Calgary Depression Scale for Schizophrenia (CDSS) is a valid tool to assess depression in schizophrenics and has been translated, adapted, and validated to be used in different non-English languages. Therefore, it may be predicted that a Spanish version of this scale will be also a valid instrument to assess symptoms of depression in patients with schizophrenia. OBJECTIVE: We determined the validity of the Spanish version of the Calgary scale (CDSS-S). METHODS: Outpatients and inpatients (n=93) diagnosed as having schizophrenia by DSM-IV criteria confirmed by SCID-IV interview were included. The Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HDRS-17 and HDRS-21 items), Montgomery-Asberg Depression Rating Scale (MADRS), Extrapyramidal Symptoms Rating Scale (ESRS), and Barnes Acathisia Rating Scale were administered by a first rater, whereas the CDSS-S was assessed by a second independent rater. RESULTS: The internal consistency (Cronbach's alpha 0.83) and the interrater reliability (>0.73 intraclass correlation coefficient [ICC] for single items and 0.92 for total score) were good. The test-retest reliability was high (ICC of 0.89). The scale showed a good construct validity with statistically significant correlations with HDRS-17, HDRS-21, MADRS, and G6 item (depression) of PANSS. The CDSS showed no correlation with the positive subscale of PANSS and a weak correlation with the negative subscale, general psychopathology subscale, and total score of PANSS. A cut point of five showed 94.7% sensitivity, 86.5% specificity, and 70% and 98% positive and negative predictive values, respectively. CONCLUSIONS: The Spanish version of CDSS is a valid instrument to assess depressive episodes for stabilized and acute patients with schizophrenia.     

An efficacy analysis of olanzapine treatment data in schizophrenia patients with catatonic signs and symptoms

Thirty-five patients suffering from schizophrenia, as diagnosed by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, were preselected from 7 clinical trials according to a priori criteria of catatonic signs and symptoms based on 3 Positive and Negative Syndrome Scale (PANSS) items: scores for PANSS item 19 (mannerism and posturing) and either item 4 (excitement) or item 21 (motor retardation) had to exceed or equal 4 at baseline. This particular patient population represents a severely psychotic sample: mean +/- SD PANSS total scores at baseline were 129.26 +/- 19.76. After I week of olanzapine treatment, mean PANSS total score was decreased significantly (-13.14; p < .001), as was mean PANSS total score after 6 weeks of olanzapine treatment (-45.16; p < .001); additionally, the positive subscale, negative subscale, and mood scores improved significantly. A significant improvement in the catatonic signs and symptoms composite score was also observed at week 6 (-4.96; p < .001). The mean +/- SD daily dose of olanzapine was 18.00 +/- 2.89 mg after 6 weeks of treatment. The present data analysis suggests the efficacy of olanzapine in the treatment of severely ill schizophrenic patients with nonspecified catatonic signs and symptoms.     

Brief PANSS to assess and monitor the overall severity of schizophrenia

Aims: The aim of the present study was to develop a subscale of the Positive and Negative Syndrome Scale (PANSS) that would be brief and sensitive to changes in the clinical features of schizophrenia (i.e. the Brief PANSS, or bPANSS). Methods: The PANSS before and after treatment, and the Clinical Global Impression–Change (CGI‐C) was rated for 714 schizophrenia patients. Of these, Clinical Global Impression–Severity (CGI‐S) was also evaluated in 30 of these patients. The bPANSS items were extracted from full PANSS items based on the following aims: (i) to develop a brief scale; (ii) to develop a scale sensitive to changes resulting from antipsychotic treatment; and (iii) to reflect the broad spectrum of schizophrenia symptoms. Results: The following six items were extracted to serve as the bPANSS: delusion, suspiciousness, emotional withdrawal, passive/apathetic social withdrawal, tension, and unusual thought content. The coefficients of correlation between the bPANSS and full PANSS before and after treatment were 0.86 and 0.92, respectively (both P < 0.001). The coefficient of correlation between the degrees of change in the scores for the bPANSS and the full PANSS was 0.93 (P < 0.001), and that between delta bPANSS and CGI‐C was 0.73 (P < 0.001). Conclusions: bPANSS is able to capture the overall clinical features of schizophrenia within a short assessment period.     

The Concept of Tension in Philosophy

Dysfunctional emotional processing affects social functioning in patients with schizophrenia. However, the relationship between emotional perception and response in social interaction has not been elucidated. Twenty-seven patients with schizophrenia and 27 normal controls performed a virtual reality social encounter task in which they introduced themselves to avatars expressing happy, neutral, or angry emotions while verbal response duration and onset time were measured and perception of emotional valence and arousal, and state anxiety were rated afterwards. Self-reported trait-affective scale scores and the Positive and Negative Syndrome Scale (PANSS) ratings were also obtained. Patient group significantly underestimated the valence and arousal of angry emotions expressed by an avatar. While valence and arousal ratings of happy avatars were comparable between groups, patient group reported significantly higher state anxiety in response to happy avatars. State anxiety ratings significantly decreased from encounters with neutral to happy avatars in normal controls while no significant decrease was observed in the patient group. The Social Anhedonia Scale and PANSS negative symptom subscale scores (blunted affect, emotional withdrawal, and passive/apathetic social withdrawal items) were significantly correlated with state anxiety ratings of the encounters with happy avatars. These results suggest that patients with schizophrenia have interference with the experience of pleasure in social interactions which may be associated with negative symptoms.     

Elevated serum levels of C-reactive protein are associated with more severe psychopathology in a subgroup of patients with schizophrenia

The present study examined the hypothesis that elevated serum levels of C-reactive protein (CRP) would be associated with more severe clinical symptoms in patients with schizophrenia. Twenty-six inpatients with schizophrenia or schizoaffective disorder were enrolled. Serum levels of CRP were measured, and each patient was assessed with the Positive and Negative Syndrome Scale (PANSS). Subjects with CRP levels above the normal range (CRP>0.50 mg/dl, elevated CRP group, N=5) scored significantly higher than those with CRP levels in the normal range (CRP相似文献   

利培酮治疗氯氮平无效的难治性精神分裂症

目的：探讨利培酮对氯氮平治疗无效的难治性精神分裂症是否有效。方法：对３１例氯氮平治疗无效的难治性精神分裂症住院患者改用得培酮治疗。结果：第８周末，阴性与阳性症状量表（ＰＡＮＳＳ）总分较疗前下降≥２０％者１９例（６１．３％）；≥５０％者１２例（３８．７％）。ＰＡＮＳＳ总分、阳必 状和一般精神病理学症状分量表积分的平均秩和于第２周末较疗前显著下降（Ｐ〈０．０５～０．０１）；阴性症状分量表积分于第４周末     

Depressive,positive, negative and parkinsonian symptomsin schizophrenia

OBJECTIVE: Depressive symptoms are common in schizophrenia but their relationship to the positive and negative symptoms of the disorder and to extrapyramidal side-effects remains unclear.Considerable overlap exists between these symptom clusters when rated with traditional clinical rating scales. The aim of this study was to investigate the relationship of depressive to positive, negative and parkinsonian symptoms using the recent adaptation of the Positive and Negative Syndrome Scale (PANSS). METHOD: The study involved the cross-sectional measurement of symptoms in a sample of community-treated and hospitalized patients with schizophrenia. Structured assessment included thePANSS, Montgomery-Asberg Depression Rating Scale (MADRS) and the Extrapyramidal Side Effects Rating Scale (ESRS). RESULTS: Depressive symptoms were common and correlated with positive and negative symptoms. These correlations were of a similar magnitude using either the original PANSS factor structure or the newer pentagonal model. The overlap between depressive and negative symptoms was limited to certain items in the rating scales and there was a clear separation between these symptom clusters and the other items. Parkinsonian symptoms also correlated with negative symptoms rated with either PANSS model. CONCLUSION: Use of the pentagonal PANSS model does not improve its capacity to distinguish between depressive and negative symptoms. Positive, negative, parkinsonian and depressive symptoms overlap using common rating scales but there appears to be some separation between these symptom domains when rated with individual scale items rather than total scale scores.     

One-year follow-up of patients with first-episode schizophrenia (comparison between remitters and non-remitters)

Patients admitted to hospital after being diagnosed with first-episode schizophrenia were comprehensively assessed prior to acute treatment (on admission), at the end of the acute treatment (at discharge), and at follow-up after 1 year. The psychopathology was evaluated using the Positive and Negative Syndrome Scale (PANSS). 93 patients were reassessed after 1 year. 73/93 (78%) of the patients fulfilled the criteria for remission. No statistically significant differences in the total PANSS or subscales scores were found between remitters and non-remitters before or after the first episode treatment. However, non-remitters had a significantly higher total PANSS score after 1 year than remitters. There was no significant difference in mean psychopathology on admission or at discharge, with the exception of items conceptual disorganization, difficulty in abstract thinking, and lack of judgment and insight between remitters and non-remitters. However, significantly higher mean values were found for all items after 1 year in non-remitters than remitters. On admission the occurrence of positive, negative and general symptoms was balanced; at discharge and after 1 year negative and general symptoms were the most frequently observed. At the 1-year follow-up the impairment of insight and judgment is one of the most frequent symptoms in both remitters (10%) and non-remitters (70%).     

Assessing positive and negative symptoms in outpatients with schizophrenia and mood disorders

The Positive and Negative Syndrome Scale (PANSS) was developed to assess symptomatology in inpatients with schizophrenia. We examined its reliability and validity among outpatients with schizophrenia (N = 75) and mood disorders (N = 61). Because the hypothesized three-scale structure of the PANSS has not been supported by existing research, we also examined its factor structure. Interrater reliability for individual items and the positive and negative scales was demonstrated. Evidence supported the internal consistency of each scale in the overall sample and the schizophrenia group but was mixed among those with mood disorders. PANSS scores were higher in the schizophrenia group. These scores, in turn, were lower than those generally reported among inpatients with schizophrenia, providing known-groups validity evidence. Four of five factors were similar to those reported among inpatients with schizophrenia. Together, these results support the use of the PANSS among outpatients and reinforce existing support for assessing positive and negative symptoms in mood disorders.     

The Greek version of the calgary depression scale for schizophrenia

The aim of this study was to evaluate the reliability and validity, as well as the specificity, of the Greek version of the Calgary Depression Scale for Schizophrenia (CDSS). Schizophrenic inpatients consecutively admitted at the Eginition Hospital, University of Athens, were included in the study. Patients were assessed on admission using the CDSS, the Hamilton Depression Rating Scale (HDRS), the Positive and Negative Syndrome Scale (PANSS), the Rating Scale for Extrapyramidal Side Effects (RSESE), the Rating Scale for Drug-Induced Akathisia (RSDIA) and the Abnormal Involuntary Movement Scale (AIMS). The CDSS was found to have a high inter-rater reliability, as well as test-retest reliability or split-half reliability. The internal consistency of the CDSS was good (a=0.87). There were positive correlations between the CDSS and the HDRS, or the depression cluster of the PANSS. The mean score on the CDSS showed no significant correlations with that of the PANSS negative subscale (r=0.123); a negative but not significant correlation with that of the PANSS positive subscale (r=-0.036); a weak correlation with that of the PANSS general psychopathology subscale (r=0.218); and no significant correlations with that of the RSESE (r=0.197), the RSDIA (r=0.160) or the AIMS (r=0.031). Our results give further support to the reliability, the validity, and the specificity of the CDSS.     

Examination of formal thought disorder and its clinical correlates with the Turkish Version of the Thought and Language Disorder Scale (TALD-TR) in schizophrenia

BackgroundFormal thought disorder (FTD) is considered to be a fundamental feature of schizophrenia. This study aims to analyze psychometric properties of the Turkish version of “Thought and Language Disorder Scale (TALD)” and investigate the relationship between FTD and various clinical characteristics in patients with schizophrenia.MethodsTALD was adapted into Turkish and applied to a total of 149 participants of which 114 had DSM-5 psychiatric diagnoses (schizophrenia N = 70, mania N = 20, depression N = 24) and 35 were healthy controls. Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale, Young Mania Rating Scale, and Clinical Global Impression were administered to detect illness severity.ResultsThe principal component analyses revealed that the Turkish version of TALD (TALD-TR) consisted of four factors including the Objective Positive (OP), Subjective Negative (SN), Objective Negative (ON) and Subjective Positive (SP) symptom dimensions which were in line with the original TALD factorial structure. It was concluded that TALD-TR shows strong construct validity and high interrater reliability. The correlation analyses with TALD-TR and PANSS showed that there are positive correlations between the TALD-TR total score and the PANSS total and subscale scores. Each diagnostic group showed the distinct pattern of FTD. The mania group exhibited the highest mean total score in the OP, whereas the schizophrenia group exhibited the highest mean total score in the ON factor. In the schizophrenia group, the severity of FTD correlated positively with duration of illness and negatively with age at onset of illness.ConclusionAdaptation of TALD into different languages seems to be possible, bringing in an international tool for research on FTD.     

Clozapine-induced QEEG changes correlate with clinical response in schizophrenic patients: a prospective, longitudinal study

BACKGROUND: The changes of theta activity (3.5-7 Hz) in the quantitative electroencephalography (QEEG) and serum clozapine levels and their correlation with clinical response, measured by the Positive and Negative Syndrome Rating Scale (PANSS) for schizophrenia, were examined prospectively in 16 patients suffering from schizophrenia during 18 weeks of clozapine (CLO) treatment. METHODS: Evaluations were performed on five occasions: before the initiation of CLO treatment at baseline and after 1, 3, 10, and 18 weeks of treatment. Doses of CLO starting from 50 mg/day were determined on the basis of clinical response. In the PANSS subscales for positive and negative symptoms, a significant (P < 0.05) improvement was observed after the first week, and in the subscale for general symptoms, improvement was seen after three weeks of treatment with CLO. A significant increase in theta power (P < 0.01) was found after three weeks of CLO treatment in the electrodes over the fronto-central scalp area, most distinctly in the midline. RESULTS: After three weeks we observed significant inverse correlations between the theta power increase and the changes in PANSS subscales for negative (P < 0.01) and positive (P < 0.05) symptoms, and after 10 weeks, between the theta power increase and the change in PANSS subscales for general (P < 0.05) and positive (P < 0.05) symptoms. After 18 weeks a trend of inverse correlation between the PANSS subscales for general and negative symptoms and the right and midline theta power increase was observed, but not with regard to positive symptoms. There were trends, but no significant correlations, between CLO treatment response and serum CLO levels. CONCLUSIONS: These findings indicate that the change in the theta frequency in QEEG and particularly in the midline electrodes over the fronto-central scalp area might be a more sensitive indicator for the evaluation of CLO treatment adequacy than the serum CLO level.     

An excitement subscale of the Positive and Negative Syndrome Scale

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.     

Rater evaluations for psychiatric instruments and cultural differences: the positive and negative syndrome scale in china and the United States

ABSTRACT: This article compares Positive and Negative Syndrome Scale (PANSS) data from Chinese and American inpatients with chronic schizophrenia to show how differences in item ratings may reflect cultural attitudes of raters. The Chinese sample (N = 504) came from Beijing Huilongguan Hospital. The American sample came from 268 PANSS assessments of Clinical Antipsychotic Trials of Intervention Effectiveness subjects hospitalized for 15 days or more to optimize equivalence of the samples. When controlling for age and sex, the Chinese sample scored significantly lower for total score by 25% (p < 0.0001), for the positive subscale by 35% (p < 0.0001), and on the general subscale by 32% (p < 0.0001) but not significantly different on the negative subscale score (+0.26%; p = 0.76). However, the Chinese sample scored 26% higher on the item on poor rapport (p < 0.0001), 10.2% higher on passive social withdrawal (p = 0.003), and most notably 46% higher on the item on lack of judgment and insight (p < 0.0001). These results remain broadly consistent across sex subgroup analyses. Differences seem to be best explained by both cultural differences in patient clinical presentations and varying American and Chinese cultural values affecting rater judgment.     

Validated five-factor model of Positive and Negative Syndrome Scale for schizophrenia in Chinese population

The Positive and Negative Syndrome Scale (PANSS) is the most widely used instrument to assess the severity of symptoms of schizophrenia. Most studies have showed that PANSS measures five dimensions of symptomatology of schizophrenia. However, few studies have ever investigated the structure of PANSS in Chinese schizophrenia population. We recruited two large independent study samples including 903 and 942 Chinese schizophrenia patients and examined the underlying structure of PANSS. By building a confirmatory factor analysis (CFA) model based on the factor loadings of the exploratory factor analysis (EFA) and by testing the CFA model in an independent validation sample, we found that PANSS scores consisted of five factors, which were positive factor, negative factor, excitement factor, depression factor, and cognitive factor. The items loaded on these factors were similar to the consensus items published in previous studies except for PANSS items P2 conceptual disorganization, P5 grandiosity, N5 abstract thinking, and G11 poor attention. This difference might be due to the influence of culture on clinical presentation of schizophrenia. By elucidating the structure, symptoms of Chinese schizophrenia patients could possibly be deconstructed and investigated in future studies.