The evolution of illness phases in schizophrenia: A non-parametric item response analysis of the Positive and Negative Syndrome Scale

Khan, Anzalee; Lindenmayer, Jean Pierre; Opler, Mark; Kelley, Mary E.; White, Leonard; Compton, Michael T.; Gao, Zimeng; Harvey, Philip D.

doi:10.1016/j.scog.2014.01.002

Cited by 6 publications

(5 citation statements)

References 52 publications

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“…These results might differ for patients who were clinically stable or being successfully treated with medications, a direction for future work. This is supported by the finding that pathological characteristics differ among first-episode, chronic and ambulatory patients with Schizophrenia (Khan et al, 2014), as well as the finding that the factor structure differed across treatment stage.…”

Section: Discussionmentioning

confidence: 70%

“…Our secondary hypothesis is that the PANSS the factor structure might change before and after treatment, partially due to the prominence of positive symptoms prior to treatment. A change in the factor structure is additionally supported by the recent finding that the PANSS item relationships differ by illness phase (Khan et al, 2014). Collectively, this paper assesses whether the failure of PANSS models to replicate across samples is due to low-loading individual items, and whether the symptom structure measured by the PANSS might change in response to treatment because of the disproportionate response of the positive symptom domain to interventions.…”

Section: Introductionmentioning

confidence: 74%

“…Factorial change could suggest instability in the consistency and accuracy of the actual measurement (Meredith, 1993; Vandenberg and Lance, 2000), a violation of methodological assumptions such as ordinality (Kelley et al, 2013) or differences in the subpopulations being studied (Khan et al, 2014). Factorial invariance is analogous to measuring weight using a different scale across subjects, where true differences among patients and treatments may be either blurred or artificially introduced by the variability among the measurement instruments used.…”

Section: Introductionmentioning

confidence: 99%

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Sparse factors for the positive and negative syndrome scale: Which symptoms and stage of illness?

Anderson¹,

Wilcox

Savitz

et al. 2015

Psychiatry Research

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The Positive and Negative Syndrome Scale (PANSS) is frequently described with five latent factors, yet published factor models consistently fail to replicate across samples and related disorders. We hypothesize that (1) a subset of the PANSS, instead of the entire PANSS scale, would produce the most replicable five-factor models across samples, and that (2) the PANSS factor structure may be different depending on the treatment phase, influenced by the responsiveness of the positive symptoms to treatment. Using exploratory factor analysis, confirmatory factor analysis and cross validation on baseline and post-treatment observations from 3647 schizophrenia patients, we show that five-factor models fit best across samples when substantial subsets of the PANSS items are removed. The optimal model at baseline (five factors) omits 12 items: Motor Retardation, Grandiosity, Somatic Concern, Lack of Judgment and Insight, Difficulty in Abstract Thinking, Mannerisms and Posturing, Disturbance of Volition, Preoccupation, Disorientation, Excitement, Guilt Feelings and Depression. The PANSS factor models fit differently before and after patients have been treated. Patients with larger treatment response in positive symptoms have larger variations in factor structure across treatment stage than the less responsive patients. Negative symptom scores better predict the positive symptoms scores after treatment than before treatment. We conclude that sparse factor models replicate better on new samples, and the underlying disease structure of Schizophrenia changes upon treatment.

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Section: Discussionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sparse factors for the positive and negative syndrome scale: Which symptoms and stage of illness?

Anderson¹,

Wilcox

Savitz

et al. 2015

Psychiatry Research

View full text Add to dashboard Cite

show abstract

“…The generalizability of a restricted PANSS by symptom presentation is also supported by the work of Khan and colleagues using item response theory, which showed variation in the PANSS items quality within schizophrenia based upon illness phase (Khan et al, 2011; Khan et al, 2014). The relationship between the negative symptom structure and executive functioning may depend on illness duration (Bagney et al, 2013), possibly due to the change in the negative symptoms with illness duration.…”

Section: Introductionmentioning

confidence: 76%

Measuring pathology using the PANSS across diagnoses: Inconsistency of the positive symptom domain across schizophrenia, schizoaffective, and bipolar disorder

Anderson

Mansolf

Reise

et al. 2017

Psychiatry Research

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Although the Positive and Negative Syndrome Scale (PANSS) was developed for use in schizophrenia (SZ), antipsychotic drug trials use the PANSS to measure symptom change also for bipolar (BP) and schizoaffective (SA) disorder, extending beyond its original indications. If the dimensions measured by the PANSS are different across diagnoses, then the same score change for the same drug condition may have different meanings depending on which group is being studied. Here, we evaluated whether the factor structure in the PANSS was consistent across schizophrenia (n = 3647), bipolar disorder (n = 858), and schizoaffective disorder (n = 592). Along with congruency coefficients, Hancock's H, and Jaccard indices, we used target rotations and statistical tests of invariance based on confirmatory factor models. We found the five symptom dimensions measured by the 30-item PANSS did not generalize well to schizoaffective and bipolar disorders. A model based on an 18-item version of the PANSS generalized better across SZ and BP groups, but significant problems remained in generalizing some of the factors to the SA sample. Schizophrenia and bipolar disorder showed greater similarity in factor structure than did schizophrenia and schizoaffective disorder. The Anxiety/Depression factor was the most consistent across disorders, while the Positive factor was the least consistent.

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“…Te pierwsze zwane są inaczej wytwórczymi (urojenia, omamy, zaburzenia zachowania), drugie to objawy ubytkowe (alogia, anhedonia, stępienie afektu, brak spontaniczności), a trzecie dotykają sfery poznawczej (upośledzenie przetwarzania informacji, nadmierna konkretność myślenia) [3][4][5]. Zaburzenia nastroju, w tym depresja i lęk, występują u wielu pacjentów, chociaż nie należą do formalnych kryteriów diagnostycznych choroby [6,7].…”

Section: Schizofrenia -Definicja I Ogólna Charakterystykaunclassified

Nowe Kierunki Poszukiwań Leków Antypsychotycznych

Ślifirski¹,

Słowiński²,

Stefanowicz³

2015

pps

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Schizofrenia jest ciężką, przewlekłą chorobą psychiczną, dotykającą około 1% populacji. Staje się ona przyczyną skrócenia długości życia oraz wycofania z życia rodzinnego, społecznego i zawodowego. Różnorodność domen symptomatycznych, takich jak objawy pozytywne, negatywne i kognitywne, wymaga kompleksowego podejścia do leczenia. Wyniki ostatnich badań na dużą skalę, porównujących leki pierwszej i drugiej generacji, pokazały, że te drugie ani nie są skuteczniejsze, ani nie wiążą się ze znaczącą poprawą funkcji poznawczych i socjalnych. Racjonalny rozwój celowo projektowanych leków wielokierunkowych może rozwiązać te problemy terapeutyczne, prowadząc do następnej generacji leków działających na ośrodkowy układ nerwowy.

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The evolution of illness phases in schizophrenia: A non-parametric item response analysis of the Positive and Negative Syndrome Scale

Cited by 6 publications

References 52 publications

Sparse factors for the positive and negative syndrome scale: Which symptoms and stage of illness?

Sparse factors for the positive and negative syndrome scale: Which symptoms and stage of illness?

Measuring pathology using the PANSS across diagnoses: Inconsistency of the positive symptom domain across schizophrenia, schizoaffective, and bipolar disorder

Nowe Kierunki Poszukiwań Leków Antypsychotycznych

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