Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-22T19:21:06.586Z Has data issue: false hasContentIssue false

A clinimetric analysis of a BPRS-6 scale for schizophrenia severity

Published online by Cambridge University Press:  07 February 2018

Per Bech*
Affiliation:
Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
Stephen F Austin
Affiliation:
Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
Nina Timmerby
Affiliation:
Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
Thomas A Ban
Affiliation:
Vanderbilt University, Nashville, Tennessee, USA
Stine Bjerrum Møller
Affiliation:
Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
*
Per Bech, Psychiatric Research Unit, Mental Health Centre North Zealand, University of Copenhagen, Dyrehavevej 48, DK-3400 Hillerød, Denmark. Tel: +45 38 64 30 95; Fax: +45 38 64 30 99; E-mail: [email protected]

Abstract

Objective

A restricted Brief Psychiatric Rating Scale (BPRS-6) with the six schizophrenia specific items from the Positive and Negative Syndrome Scale (PANSS) has been investigated. These six items from the PANSS have recently been found to have both clinical validity and ‘unidimensionality’ in measuring the severity of schizophrenic states. The primary objective of this study was to evaluate the clinical validity of the BPRS-6. The secondary objective was to evaluate the ‘unidimensionality’ of the BPRS-6 by an ‘item response theory’ model.

Methods

The BPRS-6 was scored independently by two psychiatrists and two psychologists while viewing six open-ended videotaped interviews in patients with a DSM-III diagnosis of schizophrenia. The interviews were conducted by Heinz E. Lehmann, an experienced psychiatrist. They were focused on the psychopathology that contributed most to the ‘severity’ of the patient’s clinical state.

Results

The BPRS-6 with three positive symptoms (delusions, conceptual disorganisation, hallucinations) and three negative symptoms (blunted affect, emotional withdrawal, poverty of speech) was found to be clinically valid and captured the variables that contribute most to the severity of schizophrenia. The BPRS-6 was also found to have acceptable ‘unidimensionality’ (coefficient of homogeneity 0.45) and inter-rater reliability (inter-class-coefficient 0.81).

Conclusion

The BPRS-6 was found to capture the information that translates into the severity of schizophrenia. It has also acceptable psychometric validity.

Type
Original Article
Copyright
© Scandinavian College of Neuropsychopharmacology 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Bech, P. Clinical psychometrics. Oxford: Wiley Blackwell, 2012.Google Scholar
2 Bech, P. Measurement-based care in mental disorders. New York: Springer, 2016.Google Scholar
3 Feinstein, AR. Clinimetrics. New Haven: Yale University Press, 1987.Google Scholar
4 Tomba, E, Bech, P. Clinimetrics and clinical psychometrics: macro- and microanalysis. Psychother Psychosom 2012;81:333343.Google Scholar
5 Bech, P, Allerup, P, Rosenberg, R. The Marke-Nyman temperament scale. Evaluation of transferability using the Rasch item analysis. Acta Psychiatr Scand 1978;57:4958.Google Scholar
6 Bech, P, Allerup, P, Gram, LF et al. The Hamilton depression scale. Evaluation of objectivity using logistic models. Acta Psychiatr Scand 1981;63:290299.Google Scholar
7 Rasch, G. Probabilistic models for some intelligence and attainment tests. Copenhagen: Danish Institute for Educational Research. Expanded Edition Chicago: Chicago University Press 1980, 1960.Google Scholar
8 Hamilton, M. Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 1967;6:278296.Google Scholar
9 Timmerby, N, Andersen, JH, Søndergaard, S, Østergaard, SD, Bech, P. A systematic review of the clinimetric properties of the 6-item version of the Hamilton Depression Rating Scale (HAM-D6). Psychother Psychosom 2017;86:141149.Google Scholar
10 Kay, SR. Positive-negative symptom assessment in schizophrenia: psychometric issues and scale comparison. Psychiatr Q 1990;61:163178.Google Scholar
11 Krawiecka, M, Goldberg, D, Vaughan, M. A standardized psychiatric assessment scale for rating chronic psychotic patients. Acta Psychiatr Scand 1977;55:299308.Google Scholar
12 Ostergaard, SD, Lemming, OM, Mors, O, Correll, CU, Bech, P. PANSS-6: a brief rating scale for the measurement of severity in schizophrenia. Acta Psychiatr Scand 2016;133:436444.Google Scholar
13 Andreasen, NC, Carpenter, WT Jr, Kane, JM, Lasser, RA, Marder, SR, Weinberger, DR. Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry 2005;162:441449.Google Scholar
14 Overall, JE, Gorham, DR. The Brief Psychiatric Rating Scale. Psychological reports 1962;10:799812.Google Scholar
15 Overall, JE, Hollister, LE. Assessment of depression using the Brief Psychiatric Rating Scale. In Sartorius N, Ban TA editors Assessment of depression. Heidelberg: Springer-Verlag, 1986; p. 159178.Google Scholar
16 Blackwell, B. Heinz Edgar Lehmann, 2015. Available at inhn.org. Accessed 19 April 2016.Google Scholar
17 Roth, M. The clinical interview and psychiatric diagnosis: have they a future in psychiatric practice? Compr Psychiatry 1967;8:427428.Google Scholar
18 Mokken, RJ. Theory and practice of scale analysis. Berlin: Mouton, 1971.Google Scholar
19 Bartko, JJ. The intraclass correlation coefficient as a measure of reliability. Psychol Rep 1966;19:311.Google Scholar
20 Landis, JR, Koch, GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159174.Google Scholar
21 Molenaar, IW, Debels, P, Sijtsna, K. User’s manual MSP, a program for Mokken scale analyses for polytomous items (version 3.0). Groeningen, the Netherlands: ProGAMMA, 1994.Google Scholar
22 Siegel, S. Nonparametric statistics for the behavioural sciences. New York: McGraw Hill, 1956.Google Scholar
23 Katz, MM. Clinical trials of antidepressants. New York: Springer Verlag, 2016.Google Scholar
24 Lehmann, HE, Ban, TA, Donald, M. Rating the rater. An experimental approach to the methodological problem of interrater agreement. Arch Gen Psychiatry 1965;13:6775.Google Scholar
25 Bech, P. Rating scales for psychopathology, health status and quality of life. A compendium on documentation in accordance with the DSM-III-R and WHO systems. Berlin: Springer, 1993.Google Scholar