Syndrome Scale For Schizophrenia Research Articles

The Effectiveness of the Repetitive Transcranial Magnetic Stimulation (rTMS)with high frequency (20 Hz) on Auditory Hallucinations, Inner Speech and Working Memory in Schizophrenic Patients

Background: The purpose of the present study was to investigate the effectiveness of high frequency transcranial magnetic stimulation (rTMS) treatment (20 Hz) on auditory hallucinations, inner speech and working memory in schizophrenic patients. Materials and Methods: This study was a pretest-posttest experimental design with control group. The statistical population of this study consisted of all schizophrenic patients referring to the outpatient department of Imam Hossein hospital in 2019, 12 of whom were selected by available sampling based on inclusion and exclusion criteria then were assigned randomly into two groups of 6 each. High frequency transcranial magnetic stimulation (r TMS) treatment (20 Hz) was used for experimental group but the control group received no intervention during the study. The instruments were the positive and negative syndrome scale in schizophrenia, the inner speech questionnaire, and the Daneman and Carpenter working memory questionnaire before and after the intervention. The data were analyzed by descriptive statistics, and one-way covariance analysis (ANCOVA) and multivariate covariance analysis (MANCOVA) were used to analyze the data. Results: The results showed that there were significant differences between experimental and control group (p<0.005). The rate of auditory hallucinations and inner speech significantly decreased in comparison with pretest and control group, but the rate of active memory increased. Conclusion: Repetitive transcranial magnetic stimulation (r TMS) treatment (20 Hz) significantly reduced auditory hallucinations, inner speech and improved active memory.

The effects of high-frequency repetitive transcranial magnetic stimulation on auditory hallucinations and working memory among patients with schizophrenia

Background and aims: Schizophrenia is one of the most complicated psychiatric disorders. Some afflicted patients show resistance to routine treatments. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation technique with the potential to reduce symptoms among patients with schizophrenia. The aim of this study was to evaluate the effects of high-frequency rTMS on auditory hallucinations and working memory among patients with schizophrenia. Methods: This experimental study was conducted using a pretest-posttest controlled design. The statistical population of the study consisted of all patients with schizophrenia and auditory hallucinations who referred to the outpatient psychiatric emergency department of Imam Hossein hospital, Tehran, Iran, in 2019. In total, twelve eligible patients were recruited through convenience sampling and randomly allocated to a control and an intervention group. Participants in the intervention group individually received rTMS in ten sessions, while their counterparts in the control group received no intervention during the study. Data were collected using the diagnostic interview, the screening questionnaire for rTMS, the Positive and Negative Syndrome Scale for schizophrenia, the Varieties of Inner Speech Questionnaire, and the Working Memory Measure. Data analysis was performed using univariate and multivariate analyses of covariance. Results: The posttest mean score of auditory hallucination in the intervention group was significantly less than the control group, while the posttest mean score of working memory in the intervention group was significantly greater than the control group (P<0.05). Conclusion: This study suggests the effectiveness of rTMS in significantly reducing auditory hallucinations and improving working memory among patients with schizophrenia.

Cross-Validation of the Arabic Mini International Neuropsychiatric Interview, Module K, for Diagnosis of Schizophrenia and the Arabic Positive and Negative Syndrome Scale

The Mini International Neuropsychiatric Interview, version 6, module K (MINI6-Mod-K) is a diagnostic tool to confirm schizophrenia; whereas the Positive and Negative Syndrome Scale in Schizophrenia (PANSS) is a scale to assess psychotic symptoms severity. The objective of this study was to cross-validate the diagnostic questions (categorical) from the Arabic MINI6-Mod-K with the corresponding items’ scores (dimensional) from Arabic PANSS. Arab subjects (N = 101) were recruited from the Psychiatry Hospital in Qatar. MINI6-Mod-K was used to confirm schizophrenia diagnosis, and PANSS was administered to assess psychopathology by an independent rater. The most common symptoms according to MINI6-Mod-K were the delusions and hallucinations but the PANSS items scores ≥2.5 captured more positive responses on all the diagnostic features of schizophrenia. The cut-off PANSS scores that significantly distinguished between the presence or absence of schizophrenia features on MINI6-Mod-K were mostly between 2.5 and 3.5. Multivariate linear regression showed that negative symptoms and disorganized/catatonic behaviors independently contributed to the PANSS score on positive symptoms subscale. However, none of the symptom questions in the MINI6-Mod-K were significant predictors of the PANSS negative score. Our results showed that there is very good cross-validation between the diagnostic questions of Arabic MINI6-Mod-K and the corresponding positive cut-off scores in Arabic PANSS.

Cross-cultural adaptation of the Arabic Positive and Negative Syndrome Scale in schizophrenia: Qualitative analysis of a focus group.

As part of a project to translate and validate scales used in the diagnosis and treatment of Arab patients with schizophrenia, this study aimed to explore the experience of clinical research coordinators (CRCs) while administering the Arabic version of the Positive and Negative Syndrome Scale (PANSS) on Arab schizophrenia patients. We previously reported that the Arabic version of PANSS is a valid and reliable tool to assess Arab patients with schizophrenia. Five CRCs and the principal investigator attended focus group discussions on cultural issues in administering the PANSS. A thematic analysis approach was utilized for data coding and analysis. The results identified issues related to the translation of the instrument, the structure of the interview, the cultural sensitivity of some questions, and the procedures for rating items of the PANSS. Qualitative analysis also identified four main themes relevant to clinical assessment of patients from Middle Eastern cultures: religion, beliefs and values, gender, and semantic expressions. In conclusion, researchers or clinicians administering the PANSS scale interview in Arabic should be trained to consider the roles of local dialects, familiarity with abstract thinking, religion, and social constructs when assessing psychosis.

Retraction Note to: Effect of N-acetyl cysteine (NAC) supplementation on positive and negative syndrome scale in schizophrenia: a systematic review and meta-analysis of randomised controlled trials.

The authors have retracted this article [1] because there are fundamental errors in the data presented that undermine the conclusions drawn. All authors agree with this retraction. The authors are re-analysing their data and intend to submit a new manuscript for peer review in due course.

Effect of N-acetyl cysteine (NAC) supplementation on positive and negative syndrome scale in schizophrenia: a systematic review and meta-analysis of randomised controlled trials.

To conduct a systematic review and meta-analysis of published randomised controlled trials on the efficacy of NAC supplementation on positive and negative syndrome scale in schizophrenia. A meta-analysis was conducted, and studies were identified by a search of electronic databases from inception to May 2018. Combined and stratified analyses were used. Seven trials were identified, and data from n = 447 participants were included. Pooled analysis showed improvement of positive and negative syndrome scale following NAC treatment compared with placebo, for total (SMB = - 0.96) [95% CI - 1.69, - 0.24; P = 0.009], general (SMB = - 1.04) [95% CI - 1.80, - 0.27; P = 0.008] and negative (SMB = - 0.73) [95% CI - 1.29, - 0.17; P = 0.01] scores, respectively. Significant heterogeneity was found, and subgroup analysis showed significant reductions in studies with a treatment duration of ≤ 24weeks, with a considerable effect size on total, general, and negative scores (Total SMD = - 0.83; General SMD = - 0.67; Negative SMD = - 1.09) following NAC. NAC improved all aspects of positive and negative syndrome scale in schizophrenic populations and may be more efficacious with treatment durations up to 24weeks.

Comparing Schizophrenia Patients With a Predicted High/Low Risk of Nonresponse Receiving Treatment with Ziprasidone and Haloperidol: A Randomized-Controlled Study.

The aim of this double-blind randomized study was to evaluate the response to antipsychotic treatment in schizophrenia patients with predicted high/low risk of nonresponse identified by applying a set of well-established scales and predictors of outcome and to compare efficacy between ziprasidone and haloperidol. One hundred twelve schizophrenia patients (ziprasidone: n=54; haloperidol: n=58) were rated weekly on the Positive and Negative Syndrome Scale for Schizophrenia (PANSS), the Global Assessment of Functioning Scale (GAF), the Social and Occupational Functioning Scale (SOFAS), the Simpson-Angus Scale (SAS), and Hillside Akathisia Scale (HAS). Ninety-two patients (82%) were predicted to have a high risk of nonresponse. No significant difference regarding PANSS improvement in this subsample was found comparing ziprasidone and haloperidol (p=0.563). Also, for the total patient sample, no significant difference was found regarding the course of the PANSS total score, GAF (p=0.921), and SOFAS (p=0.658) between ziprasidone and haloperidol. Haloperidol resulted in higher scores on the SAS (p=0.001) and HAS (p=0.011). An alarmingly high number of patients were at high risk of nonresponse to antipsychotic treatment.

Validation of the Five-Factor Model of the Arabic Version of the Positive and Negative Syndrome Scale in Schizophrenia

Background: The Positive and Negative Syndrome Scale (PANSS) is a widely used assessment for patients with schizophrenia across clinical and research settings. This scale allows the classification of the psychotic symptoms to better understand the psychopathology in patients with schizophrenia. There are no available data on the different components of psychopathology in Arab patients with schizophrenia. Objectives: This study examined the factor structure of the validated Arabic version of the PANSS in a sample of Arab patients with schizophrenia. Methods: The Arabic version of the PANSS was administered to 101 patients with schizophrenia, and principal component analysis (PCA) was carried out after the cross-cultural adaptation and validation of this version. Results: This sample had more males (66.3%) than females (33.7%) with a mean age of 35.03 years (SD = 9.99). PCA showed that 28 items loaded on 5 components: cognitive, negative, excited, depressed and positive. These factors explained 63.19% of variance. The 2 remaining items, grandiosity and somatic concerns, did not load well on any of these components. Conclusion: Our results support the common 5-dimension PANSS model shown in other cultures with different languages. Nevertheless, there were minor differences, which could reflect cultural or semantic differences.

Cognition and the five-factor model of the Positive and Negative Syndrome Scale in schizophrenia

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.

Considering DSM-5: Personality Diagnostics in Patients with Schizophrenia Spectrum Disorders

The aims of this study were to examine the prevalence of personality disorders (PD) in patients with schizophrenia spectrum disorders (SSD), to examine the interaction of axis-I and axis-II symptoms to provide an estimate on the confounding potential of SSD psychopathology in the establishment of DSM-IV PD diagnoses, and to discuss implications concerning the proposed changes in DSM-5. Patients with SSD, aged 18 to 65 years, and being at least partially remitted (PANSS total score < 75) were included. PD was examined categorically and dimensionally using the SCID-II screening questionnaire and interview, and SSD psychopathology was rated using the Positive and Negative Syndrome Scale for Schizophrenia (PANSS). Forty-five patients (31 with schizophrenia) were included in the current study. Mean age was 37.2 years, and the median duration of illness was 9.5 years. Mean PANSS total score was 42.5. The cumulative prevalence of PD in our collective was 20%, with obsessive-compulsive, antisocial, and borderline PD being the most frequent. There were no cases of cluster A PD diagnoses. In the dimensional analysis, numerous correlations of small to medium effect size emerged between maladaptive personality traits and SSD psychopathology. PD is present in a clinically relevant subgroup of SSD patients and has to be recognized in SSD treatment. Currently, it remains unclear to what extent correlations between personality traits and SSD symptoms can be explained by content overlap or co-variation of SSD psychopathology and PD traits. SSD psychopathology may bias PD diagnostics and lead to a higher percentage of categorical PD diagnoses, especially considering the proposed changes in DSM-5.

Are Ratings on the Positive and Negative Syndrome Scale for Schizophrenia Biased by Personality Traits?

The aim of this study was to estimate the potential bias by personality traits for ratings on the Positive and Negative Syndrome Scale (PANSS). Personality dimensions (five factor model), personality traits (SCID-II) and PANSS scores were assessed prospectively in 45 patients with schizophrenia spectrum disorders (SSD). Borderline (r=0.34; p=0.021), avoidant (r=0.66; p<0.001) and depressive (r=0.51; p<0.001) personality traits were significantly correlated with the PANSS total score. There were significant correlations for all PANSS subscores with the exemption of PANSS positive. In multivariate analyses, the final models for PANSS total score and PANSS depressive explained a total of 45.3% and 54.3% of the variance. Avoidant traits could lead to a difference of 13.1 (95% CI: 5.6-20.7) points regarding PANSS total score, depressive traits could cause differences of 4.8 points (95% CI: 2.2-7.3) for PANSS depressive subscore. Although PANSS positive subscore and PANSS excited component are relatively robust against bias by personality traits, PANSS total score and the remaining subscores are affected to a clinically relevant degree. Outcome studies in SSD patients should control for personality traits.

Factor analysis of positive and negative syndrome scale in schizophrenia: An exploratory study

Background:Controversy persists with regard to how best we can categorize symptomatic dimension of Schizophrenia. Aim of the study was to compute factorial dimensions in Indian subset of schizophrenic patients and to compare them with five factor pentagonal model extracted in western studies.Materials and Methods:150 inpatients of Schizophrenia with acute exacerbation were subjected to PANSS rating within one week of admission and statistical calculation done based on exploratory factor analysis.Results:Five factors namely negative, autistic, activation, positive and depression were extracted wherein negative factors showed highest percentage of total variance supporting five factor modal of western literatureConclusion:A consensus is gradually emerging regarding symptomatic dimensions of Schizophrenia.

SOCIAL COGNITION AND FUNCTIONAL OUTCOME AS SEPARATE DOMAINS IN SCHIZOPHRENIA

Background: Deficits in social cognition are recognised as an important feature of schizophrenia, mainly due to their close association with poor functional outcome. Impaired functioning in the domains of processing of emotions and interpretation of behaviour of others in the social milieu appears to impact functional outcome in individuals with schizophrenia. Impairments in cognition generally cooccur in these individuals and the magnitudes of deficits in social cognition and cognition are usually strongly associated. Furthermore, whereas cognitive deficits reportedly account for 10%-40% of the variance in functional outcome, social cognition has been shown to have a unique relationship to functional outcome, beyond that of cognitive function. In otherwords, social cognitionmay be amediating factor through which cognition impacts functional outcome. However, both social cognition and functional outcome are broad constructs encompassing multiple abilities. The fact that there is a wide range of measures used to test the above domains further complicates an understanding of the association between social cognition and functional outcome. The purpose of this study was to investigate the factorial validity of social cognitive constructs against that of functional outcome in schizophrenia. Methods: The subjects were 103 individuals with schizophrenia. Facial Emotion Identification Test (FEIT), the Facial Emotion Discrimination Test (FEDT), the Social Cue Recognition Test (SCRT) and the Situational Features Recognition Test (SFRT) were used as measures of social cognition. Cognitive tests were chosen in order to assess a wide range of cognitive domains and were consistent with batteries generally used in the schizophrenia literature. Functional outcome was assessed using two measures: the Quality of Life Scale (QLS) and the Social Functioning Scale (SFS). The Assessment of Interpersonal Problem Solving (AIPPS) scale, which consists of three subscales, was used as a measure of social problem solving. Symptoms were assessed with the Positive and Negative Syndrome Scale for Schizophrenia (PANSS). Results: Using a Principal Component Analysis (PCA) with varimax rotation all social cognitive tasks (i.e. FAIT, FADT, SCRT and SFRT) loaded on factor 1 (SOC COG), all three AIPPS sub-scales loaded on factor 2 (SOCPROBLEM), andbothSFS andQLS loadedon factor 3 (SOC FUNCTION). SOC COG was significantly associated with cognition (r=.54, p<0.001) and with positive (r=-.28, p<0.01) and negative symptoms (r=-.23, p<0.5). SOC PROBLEM was associated with positive (r=-.22, p<0.05) andnegative symptoms (r=-.26, p<0.05) andSOCFUNCTIONwas significantlyassociatedwithpositive (r=-.47, p<0.001) and negative symptoms (r=-.54, p<0.001). Discussion: The factor analysis clearly suggests that social cognition and social functioning are separate constructs. Interestingly a measure of social problem solving that has been at times considered a measure of functioning was differentiated from both social cognition and social functioning. Social cognition was the only factor that was significantly associated with cognition suggesting cognitive underpinning to social perception, social knowledge, and the ability to recognise affect in others. Further, all three factors correlated with both positive and negative symptoms suggesting that interpretation and evaluation of events in the social environment as well as social interactions in schizophrenia may depend on the level of psychotic symptoms.

Swedish experiences with the structured clinical interview for the positive and negative syndrome scale for schizophrenia (SCI-PANSS)

Already at the end of the 19th century, Hughlings-Jackson suggested that positive symptoms such as hallucinations and delusions should be kept apart from negative symptoms such as anhedonia and reduced energy in all psychoses. Both Kreapelin and Bleuler regarded the negative symptoms as fundamental in schizophrenia while the positive symptoms were regarded as being accessory, accompanying the disorder. This view was maintained for 60 years (table 1) until Schneider (1959) introduced the “first rank symptoms”, all of them positive. Schneider never advocated that these symptoms should be a sufficient basis for a diagnosis of schizophrenia. In any case, the “first rank Symptoms” have been included in most later diagnostic systems (table 1).