When first conceptualized by Stanley R Kay and myself in 1980, we anticipated that the PANSS would be valuable as both a research and clinical tool (this is clearly stated in all versions of the PANSS Manual published initially in 1992 by MultiHealth Systems Inc)--while its rapid acceptance for clinical trials made it familiar to researchers, clinicians wrongly assumed that this was a research tool only. Stanley Kay died in 1990, leaving me (metaphorically) alone to raise our child; I have of course had help from numerous others but remain perplexed re: how to get clinicians and clinical systems of care to use the PANSS as an outcome measure.
We used PANSS always in clinical trials in Romania when the focus is schizophrenia. I use PANSS quite often because I need a measurement instrument as well as CGI when I want to evaluate patients. But in a real world only researcher uses scale and the rest of psychiatrists are still use only their ,,nose and eyes,,...
As a Thai Psychiatrist, I would like to confirm that we do use PANSS a lot in evaluating treatment outcomes in schizophrenia patients especially in IPD patients in order to monitor their progress. Admittedly, this is possible when there are ward staff, especially psychiatric nurses who are trained in PANSS and are able to record them. This is not always possible for OPD patients with limited time and limited number of psychiatrists available in public service in Thailand.
I think that PANSS is very usefull to dectect slight improvement which are usually not detectable only with clinical judgment. Therefore, after the demonstration that early antipsychotic response (defined as reduction in psychopathological scale score of about 20% - mainly PANSS) could strongly predict the final response, it may be used to detect this early improvement, allowing to change the antipsychotic drug after only two weeks rather than the usual 4-6 weeks of treatment. With this aim, I think that PANSS could become popular also among clinicians.
Lewis: Good to learn that you were involved in the development of rating scale as useful as PANSS. Thank you!
Stefano: Thanks, you make useful points. Just so that I am clear, are you suggesting we need to demonstrate the usefulness of PANSS in detection of early antipsychotic response? Or has this already been demonstrated? If latter is the case, are you able to direct us to the published evidence? Apologies if I have misunderstood you.
Dear Rashid, a lot of papers showed that the early antipsychotic response could predict the response at 4 and 6 weeks of treatment. All of them employed psychopathological scales for the evaluations, mainly PANSS and BPRS. So, its usefullness has already demonstrated. However, the most part of guidelines have not yet assimilate this concept. I think that in the next years guidelines will suggest to evaluate the improvement after 2 weeks to verify the efficacy of the antipsychotic treatment, paving the way to the spread use of psychopathological scales, such as the PANSS, also in the clinical setting.
Here there are two references about the issue, but you can also look at their bibliography to find more papers on the issue:
Schizophr Res. 2009 Aug;113(1):34-40. doi: 10.1016/j.schres.2009.06.001. Epub 2009 Jun 28. Optimal thresholds of early response to atypical antipsychotics: application of signal detection methods. Chen L1, Ascher-Svanum H, Stauffer V, Kinon BJ, Kollack-Walker S, Ruberg S.
Neuropsychobiology. 2012;66(2):100-5. doi: 10.1159/000337739. Epub 2012 Jul 17.
Antipsychotic response in the first week predicts later efficacy. Giegling I1, Porcelli S, Balzarro B, Andrisano C, Schäfer M, Möller HJ, Rujescu D, Serretti A.
RE: Are there French translations of the PANSS
Yes! THREE!
1-PARISIAN FRENCH
2-HAITIAN FRENCH
3-QUEBECOIS FRENCH
The copyright holder of the PANSS is MultiHealth Systems Inc so I am required to send people to them for information re: translations--they are located in Toronto, Canada, and I am happy to collaborate with them on many things, including the scale I created and which they publish
We have used the PANSS interview in our TIPS research project - a first episode of psychosis project, but clinically we use the PANSS as a way of measuring remission and relapse in our OPUS treatment of first episode psychosis in Region Zealand, Denmark. All our clinical staff are trained in using this instrument, which is applied severel times during the 2 year treatment period. Also we use it as a screening tool for psychosis in our detection team in our TOP project, which combines an information campaign with very quick assessment of people responding on our hotline - usually within two - four days.
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