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General Note

General Note Caveats in rating the PANSS are commented on since it has been the standard scale amongst others. Double-blind studies have offered the most solid evidence, whereby independent raters assess the patients at baseline and typically the same raters follow the same patients throughout. If one wishes to maintain true blindness, every assessment can be performed by the different rater, which obviously poses two major problems—feasibility (to assure adequate number of raters) and reliability among raters.   Therefore, two possibilities in a typical study should be noted as confounding factors in quantification with the scales. First, the result of the baseline assessment will have a significant impact for later assessments. As for a rater effect at the very baseline, it is reported that a psychiatrist who saw a patient for the first time underrated the PANSS scores by 10%, compared with the ones obtained by the psychiatrist in charge who has known that patient very well.56 Second