Skip to main content



The PANSS has been ‘the standard’ scale and is frequently adopted as the primary outcome measure in clinical studies for schizophrenia. It is reasonable to assume the more number of items (and the wider the potential score distribution) in a scale, the more likely one would be able to detect a difference but at the cost of time. In order to discern any difference, it might be better to rate as many scales as possible (e.g., all of the PANSS, BPRS, SAPS, and SANS), which nonetheless would be unrealistically time-consuming and in fact has been a case for none of the 150 studies investigated herein.


Redundancy within/across the scales is also of concern. For instance, factor analyses of the PANSS have identified several components19 and as such, rating these extracted factors instead of all 30 items might even be sufficient. In line with this view, efforts are ongoing to make simpler rating scales. For instance, The Clinical Global Impression-Schizophrenia scale: CGI-SCH20 is akin to the CGI but it consists of four common symptomatic aspects (i.e., positive, negative, depressive and cognitive symptoms) in addition to global severity/change. This scale has been used in a series of naturalistic, observational investigations (The European Schizophrenia Outpatient Health Outcomes (SOHO) study).21


Affective and anxiety symptoms have not been usually assessed with the rating scale in spite of a relatively high prevalence reported in the literature,22 although it might still be possible to capture these problems with such items as depression, guilt feelings, anxiety, and tension in the PANSS for instance. The Montgomery- ├ůsberg depression rating scale: MADRS23 (10 items) has not been so frequently utilized in this population, and none of the anxiety scales has been commonly used. Another important issue is to evaluate the usefulness of subjective scales for mood and anxiety in patients with schizophrenia.


Popular posts from this blog

ADVOKATE: A Tool for Assessment of Eyewitness Evidence

ADVOCATE: A Tool for Assessment of Eyewitness Evidence It is a tool designed to assess the eyewitness evidence that how much it is reliable. It requires the user to respond to several statements/questions. Forensic psychologist, police or investigative officer can do it. The mnemonic ADVOKATE stands for: A = amount of time under observation (event and act) D = distance from suspect V = visibility (night-day, lighting) O = obstruction to the view of the witness K = known or seen before when and where (suspect) A = any special reason for remembering the subject T = time-lapse (how long has it been since witness saw suspect) E = error or material discrepancy between the description given first or any subsequent accounts by a witness.  Working with suspects (

Diagnostic test for catatonia, the lorazepam challenge test

Benzodiazepines are the mainstay of the treatment of catatonia and are also helpful as a diagnostic probe. A positive Lorazepam Challenge Test validates the diagnosis of catatonia. After we examine the patient for signs of catatonia, 1 or 2 mg of lorazepam is administered intravenously. After 5 minutes, the patient is re-examined. If there has been no change, a second dose is given, and the patient is again reassessed (46, 78). A positive response is a marked reduction (e.g., at least 50%) of catatonic signs and symptoms, as measured with a standardized rating scale. Favorable responses usually occur within 10 min (46). If lorazepam is given intramuscularly or per os, the interval for the second dose should be longer: 15′ and 30′, respectively. Many clinicians will share the experience that a “lorazepam test” not only confirms the diagnosis of catatonia but that it also makes the underlying psychopathology apparent “by permitting mute patients to speak” (79). Analogous to the lorazepa

Classification of Depression According to the ICD-10

A first depressive episode, duration at least15 days →depressive episode (F32)  A first depressive episode, severe and rapid onset, duration less than 15 days →still depressive episode (F32) A depressive episode can be mild (2 core symptoms, 2 other symptoms from the list) (32.0) moderate (2 core symptoms, 3 or preferably 4 other symptoms) (32.1) Severe (3 core symptoms, 4 other symptoms) without psychotic symptoms (32.2) (no delusion, hallucination or stupor) Severe with psychotic symptoms (above plus either delusions, hallucinations or stupor) (F32.3) Delusions can be mood-congruent or incongruent (neutral delusions e.g. delusions of reference are considered mood incongruent. None of them count towards schizoaffective disorder unless one of the first-rank)  A mild and moderate depressive episode can be  with somatic syndrome (four or more somatic symptoms, or three very severe somatic symptoms) without somatic syndrome (three or less somatic symptoms, not severe)  A severe depressi