Bar Ilan University, Ramat Gan 52900, Israel.
Psychiatry Res. 2011 Aug 15;188(3):446-52. doi: 10.1016/j.psychres.2011.03.014. Epub 2011 Apr 3.
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.
采用项目反应理论（IRT）考察阳性和阴性症状量表（PANSS）项目在评估精神分裂症症状严重程度方面的充分性。对两项慢性精神分裂症抗精神病药物多中心临床试验的基线 PANSS 评估进行了分析（n=1872）。总体而言，结果表明，PANSS（a）项目评分对阴性症状的严重程度最佳区分；（b）有过多的“严重”和“极其严重”评分选项；（c）评估在中度症状严重程度时比非常低或高的水平更可靠。分析还表明，对于原始和 IRT 修正的 PANSS，在治疗中检测具有统计学和非统计学意义的差异高度相似。在慢性精神分裂症的临床试验中，PANSS 似乎需要进行以下修改：减少评分选项、调整“缺乏判断力和洞察力”，以及改进严重症状评估。
