Rasch analysis of the PANSS negative subscale and exploration of negative symptom trajectories in first-episode schizophrenia: data from the OPTiMiSE trial

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  • Lone Baandrup, Mental Health Center Glostrup, Københavns Universitet
  • ,
  • Peter Allerup
  • Mette Ø. Nielsen, Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Københavns Universitet
  • ,
  • Nikolaj Bak, H. Lundbeck A/S
  • ,
  • Signe W. Düring, Mental Health Center Glostrup, Københavns Universitet
  • ,
  • Stefan Leucht, Technical University of Munich
  • ,
  • Silvana Galderisi, University of Campania Luigi Vanvitelli
  • ,
  • Armida Mucci, University of Campania Luigi Vanvitelli
  • ,
  • Paola Bucci, University of Campania Luigi Vanvitelli
  • ,
  • Celso Arango, Complutense University
  • ,
  • Covadonga M. Díaz-Caneja, Complutense University
  • ,
  • Paola Dazzan, King's College London, South London and Maudsley NHS Foundation Trust
  • ,
  • Philip McGuire, King's College London, South London and Maudsley NHS Foundation Trust
  • ,
  • Arsime Demjaha, King's College London, South London and Maudsley NHS Foundation Trust
  • ,
  • Bjørn H. Ebdrup, Mental Health Center Glostrup, Københavns Universitet
  • ,
  • René S. Kahn, Brain Center Rudolf Magnus, Icahn School of Medicine at Mount Sinai
  • ,
  • Birte Y. Glenthøj, Mental Health Center Glostrup, Københavns Universitet

The observed heterogeneity in negative symptom treatment response may be partly attributable to inadequate measurement tools or limitations in methods of analysis. Previous Item Response Theory models of the Positive and Negative Syndrome Scale (PANSS) have only examined samples of chronic patients and with mixed results. We examined the scalability of the negative subscale embedded in the PANSS and subsequently explored negative symptom trajectories across four weeks of amisulpride treatment. Data were derived from the OPTiMiSE trial comprising 446 patients with first-episode schizophrenia or schizophreniform disorder. Using the Rasch Model to examine psychometric properties of the PANSS negative subscale, we found that the composite score across items was not an adequate measure of negative symptom severity. Consequently, we chose an exploratory statistical approach involving Principal Component Analysis which yielded one significant component clustering into two significant symptom trajectories: 1) Subtle but constant decrease in negative symptom severity (N = 323; 72%), and 2) symptom instability across visits (N = 19; 4%). Explorative analytic methods as presented here may pave the way for more efficient and sensitive methods of analyzing negative symptom response in research and in clinical practice.

OriginalsprogEngelsk
Artikelnummer112970
TidsskriftPsychiatry Research
Vol/bind289
Antal sider8
ISSN0165-1781
DOI
StatusUdgivet - 2020

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