Geck Simon, Roithmeier Maximilian, Bühner Markus, Wehr Sophia, Weigel Lucia, Priller Josef, Davis John M, Leucht Stefan
Department of Psychiatry and Psychotherapy, School of Medicine and Health, Technical University of Munich, Klinikum Rechts der Isar, Ismaningerstraße 22, Munich, 81675, Germany.
Department of Psychology, Ludwig Maximilian University of Munich, Leopoldstr. 13, Munich, 80802, Germany.
EClinicalMedicine. 2025 Apr 11;82:103155. doi: 10.1016/j.eclinm.2025.103155. eCollection 2025 Apr.
The Positive and Negative Syndrome Scale (PANSS) is the most widely used tool for assessing the symptoms of schizophrenia. Despite its widespread use, the psychometric properties of the PANSS have not been systematically reviewed. This study fills that gap in the scientific literature.
We utilized the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline for systematic reviews and meta-analytical procedures to assess the psychometric properties of the PANSS in its original three-subscale form as well as the quality level of the evidence available. On this basis we formulated recommendations for future research and use. A study protocol was registered under 10.17605/OSF.IO/5EGMD. The search period was until February 21, 2024.
We included 119 publications. According to COSMIN, the PANSS demonstrated sufficient reliability, construct validity, and responsiveness; but had significant shortcomings in content validity and structural validity. The original three-factor model showed poor structural validity, leading to its COSMIN classification as "not recommendable". The subscales showed overall acceptable measurement properties. However, the lack of structural validity of the three-subscale model renders its subscales less useful. Moreover, the PANSS negative subscale does not cover all domains of the National Institute of Mental Health consensus. Due to the length of the instrument (30-50 min), it is barely useable in clinical practice.
Although the PANSS is the standard scale for schizophrenia symptom severity, its shortcomings regarding fundamental psychometric domains and practical applicability warrant the development of new scales for which appropriate methods should be applied from the start.
There was no specific funding source for this research.
阳性与阴性症状量表（PANSS）是评估精神分裂症症状最广泛使用的工具。尽管其使用广泛，但PANSS的心理测量特性尚未得到系统综述。本研究填补了科学文献中的这一空白。
我们利用基于共识的健康测量工具选择标准（COSMIN）指南进行系统综述和荟萃分析程序，以评估原始三分量表形式的PANSS的心理测量特性以及现有证据的质量水平。在此基础上，我们为未来的研究和使用制定了建议。一项研究方案已在10.17605/OSF.IO/5EGMD下注册。检索期截至2024年2月21日。
我们纳入了119篇出版物。根据COSMIN，PANSS表现出足够的信度、结构效度和反应度；但在内容效度和结构效度方面存在显著不足。原始的三因素模型显示出较差的结构效度，导致其在COSMIN分类中为“不推荐”。分量表显示出总体可接受的测量特性。然而，三分量表模型缺乏结构效度使其分量表的作用较小。此外，PANSS阴性分量表未涵盖美国国立精神卫生研究所共识的所有领域。由于该工具的长度（30 - 50分钟），它在临床实践中几乎无法使用。
尽管PANSS是精神分裂症症状严重程度的标准量表，但其在基本心理测量领域和实际适用性方面的缺点值得开发新的量表，且应从一开始就应用适当的方法。
本研究没有特定的资金来源。
