Abstract
Scales measuring positive and negative symptoms in schizophrenia remain the primary mo Scales measuring positive and negative symptoms in schizophrenia remain the primary mode of assessing and diagnosing schizophrenia by clinicians and researchers. The scales are mainly used to monitor the severity of positive and negative symptoms and track treatment response in schizophrenics. Although these scales are widely used, quality as well as general utility of each scale varies. The quality is determined by the validity and reliability of the scales. The utility of the scale is determined by the time of administration and the settings for which the scales can be administered in research or clinical settings. There are relatively fewer articles on the utility of newer scales like CAINS (Clinical Assessment Interview for Negative Symptoms) and the BNSS (Brief Negative Symptom Scale) that compare them to the older scales PANSS (Positive and Negative Symptoms Scale), SAPS (Scale for the Assessment of Positive Symptoms) SANS (the Scale for the Assessment of Negative Symptoms), NSA-16 (Negative Symptom Assessment-16) and CGI-SCH (Clinical Global Impression Schizophrenia.The older scales were developed more than 30 years ago. Since then, our understanding of negative symptoms has evolved and currently there are newer rating scales evaluating the validity of negative symptoms. The older scales do not incorporate the latest research on negative symptoms. CAINS and BNSS are attractive for both their reliability and their concise accessible format, however, a scale that is simpler, accessible, user-friendly, that incorporates a multidimensional model of schizophrenia, addresses the psychosocial and cognitive component has yet to be developed.
Highlights
Since Eugen Bleuler coined the term “schizophrenia” in 1908 as a name for what was originally known as “dementia praecox,” schizophrenia continues to be a disorder that remains challenging to define
The older scales were developed more than 30 years ago
The main objective of this paper is to review and assess utility of well-established scales: the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), the Positive and Negative Symptoms Scale (PANSS), the Negative Symptom Assessment (NSA-16) and the Clinical Global Impression Schizophrenia (CGI-SCH) and to compare these scales to the newer screening tools: The Clinical Assessment Interview for Negative Symptoms (CAINS) and The Brief Negative Symptom Scale (BNSS)
Summary
Since Eugen Bleuler coined the term “schizophrenia” in 1908 as a name for what was originally known as “dementia praecox,” schizophrenia continues to be a disorder that remains challenging to define. Various scales and instruments have been proposed and developed for both clinicians and researchers to screen for schizophrenia, and these different instruments reflect the different understandings of how schizophrenia can be best defined and classified in terms of its symptoms. Scales developed to screen for schizophrenia have primarily focused on assessing patients through the use of positive and negative symptoms. The PANSS, SAPS, and SANS are well-established scales that have been used to objectively assess for schizophrenia symptoms. Initially, the progress in the development of new pharmacological treatment for the negative symptoms of schizophrenia is restricted by limitations of available assessment tools. The multi-site Collaboration to Advance Negative Symptoms Assessment was established to develop and validate a new clinical rating scale, CAINS (The Clinical Assessment Interview for Negative Symptoms), to address limitations of existing measures. To the author's knowledge, there has not yet been any review article evaluating older scales (PANSS, SAPS, SANS) and comparing them with the newer scales (CAINS and BNSS)
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