title: Symptom assessment in early psychosis: the use of well-established rating scales in clinical high-risk and recent-onset populations.
abstract: Symptom assessment in early psychosis research typically relies on scales validated in chronic schizophrenia samples. Our goal was to inform investigators who are selecting symptom scales for early psychosis research. We described measure characteristics, baseline scores, and scale inter-relationships in clinical-high-risk (CHR) and recent-onset psychotic disorder (RO) samples using the Positive and Negative Syndrome Scale, Brief Psychiatric Rating Scale, Scale for the Assessment of Positive Symptoms, and Scale for the Assessment of Negative Symptoms; for the CHR group only, we included the Scale of Prodromal Symptoms. For investigators selecting symptom measures in intervention or longitudinal studies, we also examined the relationship of symptom scales with psychosocial functioning. In both samples, symptom subscales in the same domain, across measures, were moderately to highly intercorrelated. Within all measures, positive symptoms were not correlated with negative symptoms, but disorganized symptoms overlapped with both positive and negative symptoms. Functioning was significantly related to negative and disorganized, but not positive, symptoms in both samples on most measures. Findings suggest strong overlap in symptom severity ratings among the most common scales. In recent-onset samples, each has strengths and weaknesses. In CHR samples, they appear to add little information above and beyond the SOPS.
authors.affiliation: Department of Psychiatry, University of California, 401 Parnassus Avenue, Box PAR-0984, San Francisco, CA 94143, United States; Palo Alto Medical Foundation Research Institute, Palo Alto, CA, United States.
authors.forename: Daniel
authors.initials: D
authors.lastname: Fulford
authors.affiliation: Department of Psychiatry, University of California, 401 Parnassus Avenue, Box PAR-0984, San Francisco, CA 94143, United States.
authors.forename: Rahel
authors.initials: R
authors.lastname: Pearson
authors.affiliation: Department of Psychiatry, University of California, 401 Parnassus Avenue, Box PAR-0984, San Francisco, CA 94143, United States.
authors.forename: Barbara K
authors.initials: BK
authors.lastname: Stuart
authors.affiliation: Department of Psychiatry, University of California, 401 Parnassus Avenue, Box PAR-0984, San Francisco, CA 94143, United States; San Francisco VA Healthcare System, San Francisco, CA, United States.
authors.forename: Melissa
authors.initials: M
authors.lastname: Fisher
authors.affiliation: Department of Psychiatry, University of California, 401 Parnassus Avenue, Box PAR-0984, San Francisco, CA 94143, United States; San Francisco VA Healthcare System, San Francisco, CA, United States.
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Mathalon
authors.affiliation: Department of Psychiatry, University of California, 401 Parnassus Avenue, Box PAR-0984, San Francisco, CA 94143, United States; San Francisco VA Healthcare System, San Francisco, CA, United States.
authors.forename: Sophia
authors.initials: S
authors.lastname: Vinogradov
authors.affiliation: Department of Psychiatry, University of California, 401 Parnassus Avenue, Box PAR-0984, San Francisco, CA 94143, United States. Electronic address: RachelL@lppi.ucsf.edu.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Loewy
mesh_terms: D000293:Adolescent; D010054:Brief Psychiatric Rating Scale / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D062706:Prodromal Symptoms; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011594:Psychometrics; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology; D012306:Risk; D012559:Schizophrenia / Q000175:diagnosis; D012565:Schizophrenic Psychology; D063189:Symptom Assessment; D055815:Young Adult
keywords: Assessment; BPRS; Early psychosis; PANSS; SANS/SAPS; SOPS; Symptoms