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Positive and negative symptoms/syndromes in schizophrenia: reliability and validity of different diagnostic systems

Published online by Cambridge University Press:  09 July 2009

V. Peralta ,
M. J. Cuesta  and
J. De Leon
V. Peralta*
Affiliation:
Psychiatric Unit, Virgen del Camino Hospital, Pamplona, Spain; Medical College of Pennsylvania, Eppi, PA, USA
M. J. Cuesta
Affiliation:
Psychiatric Unit, Virgen del Camino Hospital, Pamplona, Spain; Medical College of Pennsylvania, Eppi, PA, USA
J. De Leon
Affiliation:
Psychiatric Unit, Virgen del Camino Hospital, Pamplona, Spain; Medical College of Pennsylvania, Eppi, PA, USA
*
1Address for correspondence: Dr Victor Peralta, Psychiatric Unit, Virgen del Camino Hospital, Irunlarrea 4, E-31008 Pamplona, Spain.
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Synopsis

The paper explores the reliability, concurrent validity and overlap of some positive/negative symptom rating scales and typological criteria in 100 schizophrenic patients. Rating scales include Andreasen's Scales for the Assessment of Positive and Negative Symptoms, Abrams and Taylor's Scale for Emotional Blunting, and Kay's Positive and Negative Syndrome Scale. Criteria for categorizing individual patients include Andreasen's and Kay's criteria for positive and negative types of schizophrenia as well as Carpenter's criteria for the deficit syndrome. The correlations among positive as well as among negative scales were high. The agreement among criteria tended to be lower. Both positive scales showed low internal consistency. Kay's negative scale had the greatest internal consistency, which suggests that it is measuring a homogeneous syndrome. All negative symptom scales and categorical syndromes identified a group of patients who were single and exhibited schizoid or schizotypal pre-morbid personality disorders, poor premorbid sexual/social adjustment, poor response to neuroleptics and poor prognosis.

Type
Research Article
Information
Psychological Medicine , Volume 25 , Issue 1 , January 1995 , pp. 43 - 50
Copyright
Copyright © Cambridge University Press 1995

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References

Abrams, R. & Taylor, M. A. (1978). A rating scale for emotional blunting. American Journal of Psychiatry 135, 266–269.Google ScholarPubMed
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, Revised 3rd (DSM-III-R). APA: Washington, DC.Google Scholar
Andreasen, N. C. (1984 a). The Scale for the Assessment of Positive Symptoms (SAPS). University of Iowa: Iowa City, IA.Google Scholar
Andreasen, N. C. (1984 b). The Scale for the Assessment of Negative Symptoms (SANS). University of Iowa: Iowa City, IA.Google Scholar
Andreasen, N. C. & Flaum, M. (1991). Schizophrenia: the characteristic symptoms. Schizophrenia Bulletin 17, 27–49.CrossRefGoogle ScholarPubMed
Andreasen, N. C. & Olsen, S. (1982). Negative v. positive schizophrenia: definition and validation. Archives of General Psychiatry 39, 789–794.CrossRefGoogle ScholarPubMed
Andreasen, N. C., Flaum, M., Swaize, V. W., Tyrell, G. & Ardnt, S. (1990). Positive and negative symptoms in schizophrenia. A critical reappraisal. Archives of General Psychiatry 47, 615–621.CrossRefGoogle ScholarPubMed
Ardnt, S., Alliger, R. J. & Andreasen, N. C. (1991). The distinction of positive and negative symptoms. British Journal of Psychiatry 158, 317–322.Google Scholar
Bartko, J. J. & Carpenter, W. T. (1976). On the methods and theory of reliability. Journal of Nervous and Mental Disease 163, 307–317.CrossRefGoogle ScholarPubMed
Bleuler, E. (1950). Dementia Praecox or the Group of Schizophrenias (Translated by Zinkin, J.). International Universities Press: New York.Google Scholar
Carpenter, W. T., Heinrichs, D. W. & Wagman, A. M. I. (1988). Deficit and non-deficit forms of schizophrenia: the concept. American Journal of Psychiatry 145, 578–583.Google Scholar
Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika 16, 297–334.CrossRefGoogle Scholar
Crow, T. J. (1980). Molecular pathology of schizophrenia: more than a disease process? British Medical Journal 280, 66–68.CrossRefGoogle ScholarPubMed
Crow, T. J. (1985). The two-syndrome concept: origins and current status. Schizophrenia Bulletin 11, 471–486.CrossRefGoogle ScholarPubMed
Davis, J. M. (1976). Comparative doses and costs of antipsychotic medication. Archives of General Psychiatry 33, 858–861.CrossRefGoogle ScholarPubMed
de Leon, J., Wilson, W. H. & Simpson, G. M. (1989). Measurement of negative symptoms in schizophrenia. Psychiatric Developments 3, 211–234.Google Scholar
de Leon, J., Simpson, G. M. & Peralta, V. (1992). Positive and negative symptoms in schizophrenia: Where are the data? Biological Psychiatry 31, 431–434.CrossRefGoogle ScholarPubMed
Fenton, W. S. & McGlashan, T. H. (1992). Testing systems for assessment of negative symptoms in schizophrenia. Archives of General Psychiatry 49, 179–184.CrossRefGoogle Scholar
Frith, C. D. (1992). The Cognitive Neuropsychology of Schizophrenia. Lawrence Erlbaum Associates: Hove.Google Scholar
Gur, R. E., Mozley, P. D., Resnick, S. M., Levick, S., Erwin, R., Saykin, A. J. & Gur, R. C. (1991). Relations among clinical scales in schizophrenia. American Journal of Psychiatry 148, 472–478.Google Scholar
Guy, W. (1976). ECDEU Assessment Manual for Psychopharmacology. Department of Health, Education, and Welfare: Washington, DC.Google Scholar
Harris, J. G. (1975). Abbreviated form of the Philips' rating scale of premorbid adjustment in schizophrenia. Journal of Abnormal Psychology 84, 129–137.CrossRefGoogle Scholar
Johnstone, E. C., Crow, T. J., Frith, C. D., Carney, M. W. P. & Price, J. S. (1978). Mechanism of the antipsychotic effect in the treatment of acute schizophrenia. Lancet i, 848–851.CrossRefGoogle Scholar
Kay, S. R. (1990). Positive-negative symptom assessment in schizophrenia: psychometric issues and scale comparison. Psychiatric Quarterly 61, 163–178.CrossRefGoogle ScholarPubMed
Kay, S. R. (1991). Positive and negative syndromes in schizophrenia: assessment and research. Clinical and Experimental Psychiatry Monograph No. 5. Brunner/Mazel: New York.Google Scholar
Kay, S. R. & Sevy, S. (1990). Pyramidical model of schizophrenia. Schizophrenia Bulletin 16, 537–545.CrossRefGoogle ScholarPubMed
Kay, S. R., Opler, L. A. & Fiszbein, A. (1986). Positive and Negative Syndrome Scale (PANSS), Rating manual. Albert Einstein College of Medicine: New York.Google Scholar
Kay, S. R., Fiszbein, A. & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin 13, 261–276.CrossRefGoogle Scholar
Kay, S. R., Opler, L. A. & Lindenmayer, J. P. (1988). Reliability and validity of the Positive and Negative Syndrome Scale for schizophrenics. Psychiatry Research 23, 99–110.CrossRefGoogle ScholarPubMed
Kirkpatrick, B., Buchanan, R. W., McKenney, P. D., Alphs, L. D. & Carpenter, W. T. (1989). The schedule for the deficit syndrome: an instrument for research in schizophrenia. Psychiatry Research 30, 119–123.CrossRefGoogle Scholar
Krawiecka, M., Goldberg, D. & Vaughan, M. A. (1977). A standardized psychiatric assessment scale for rating chronic psychotic patients. Acta Psychiatrica Scandinavica 55, 299–308.CrossRefGoogle ScholarPubMed
Landmark, I. (1982). A manual for the assessment of schizophrenia. Acta Psychiatrica Scandinavica 65 (Suppl. 298).Google Scholar
Liddle, P. F. (1987). Schizophrenic syndromes, cognitive performance and neurological dysfunction. Psychological Medicine 17, 49–57.CrossRefGoogle ScholarPubMed
McGlashan, T. H. & Fenton, W. S. (1992). The positive-negative distinction in schizophrenia. Review of natural history validators. Archives of General Psychiatry 49, 63–72.CrossRefGoogle ScholarPubMed
Norušis, M. J. (1986). The Statistical Package for Social Sciences (SPSS/PC+), Manual of Reference. SPSS, Inc: Chicago.Google Scholar
Peralta, V., de Leon, J. & Cuesta, M. J. (1992). Are there more than two syndromes in schizophrenia: a critique of the positive negative dichotomy. British Journal of Psychiatry 161, 335–343.CrossRefGoogle ScholarPubMed
Peralta, V. & Cuesta, M. J. (1994). Psychometric properties of the Positive and Negative Syndrome Scale (PANSS) in schizophrenia. Psychiatry Research 53, 31–40.CrossRefGoogle Scholar
Strauss, J. S. & Carpenter, W. T. (1974). The prediction of outcome in schizophrenia. II. Relationship between predictor and outcome variables. Archives of General Psychiatry 31, 37–42.CrossRefGoogle Scholar
Strauss, J. S., Carpenter, W. T. & Bartko, J. (1974). The diagnosis and understanding of schizophrenia. III. Speculations on the processes that underlie schizophrenic symptoms and signs. Schizophrenia Bulletin 1, 61–69.CrossRefGoogle Scholar
Venables, P. H. (1957). A short scale for ‘activity-withdrawal’ in schizophrenics. Journal of Mental Science 103, 197–199.CrossRefGoogle Scholar
Wing, J. K. (1989). The concept of negative symptoms. British Journal of Psychiatry 155, (suppl. 7), 10–14.CrossRefGoogle Scholar
Wing, J. K. & Brown, G. W. (1970). Institutionalism and Schizophrenia. Cambridge University Press: Cambridge.CrossRefGoogle Scholar