Replicating and extending the reliability, criterion validity, and treatment sensitivity of the shortened PANSS for pediatric trials.

Abstract

Do the shortened Positive and Negative Syndrome Scale (PANSS) (Kay et al., J Clin Psychiatry 58:538-546, 1987) versions recently developed from a National Institute of Mental Health (NIMH) pediatric dataset continue to perform well in a third independent randomized double-blind clinical trial of adolescents with schizophrenia? Secondary analysis of the double-blind, placebo-controlled aripiprazole pivotal trial data (N = 302) found that the 10-item (and 20-item) PANSS versions on which we have previously reported (Findling et al., J Am Acad Child Adolesc Psychiatry, https://doi.org/10.1016/j.jaac.2022.07.864 , 2023) continued to provide high reliability, strong convergent correlation with expected measures, and treatment effects that equaled those found in the 30-item adult PANSS. Our shortened PANSS, derived originally from the randomized non-placebo controlled NIMH Treatment of Early Onset Schizophrenia Spectrum study (TEOSS) (Sikich et al., Am J Psychiatry 165(11):1420-1431, 2008), and independently replicated in both the placebo-controlled paliperidone pivotal trial for adolescents with schizophrenia (Youngstrom et al., PsyArxiv, https://doi.org/10.31234/osf.io/zb695 , 2023), and now the placebo-controlled aripiprazole pivotal trial for adolescents with schizophrenia, has again performed as well as the full 30 item adult-patient derived PANSS. The findings suggest it is possible to reduce the PANSS interview by 2 thirds, thus reducing burden on families and pediatric patients as well as administration and training costs, while maintaining high reliability, validity, and sensitivity to treatment equal to that of the 30-item version.