DOI: https://doi.org/10.22263/2312-4156.2021.3.71
Assanovich M.V.
Psychometric properties and diagnostic criteria of the scale for positive symptoms assessment – SAPS in patients with schizophrenia
Grodno State Medical University, Grodno, Republic of Belarus
Vestnik VGMU. 2021;20(3):71-81.
Abstract.
Objectives. To assess psychometric properties of Scale for the Assessment of Positive Symptoms (SAPS) and to develop criteria for assessing the severity of positive symptoms in the dynamics of therapy, to clinically verify SAPS metric criteria.
Material and methods. The study involved 157 patients with the diagnosis of schizophrenia. Psychometric analysis of SAPS was carried out on the basis of the Rasch metric system with the development of criteria for assessing the severity of positive symptoms based on the index of minimum detectable changes for 95% probability (Minimum detectable change 95% – MDC95%). Clinical verification was conducted by statistical analysis of contingency tables of clinical and metric criteria using the Clinical Global Impression Scale (CGI).
Results. All items of SAPS have reasonable level of construct validity. The scale is characterized by moderate reliability (r= 0.84) and high discrimination. Factor analysis has revealed heterogeneity of SAPS metric structure: items in the first group assess hallucinatory and delusional symptoms, items in the second group characterize behavioral disorders and formal thinking disorders. The heterogeneity of SAPS reflects dimensional structure of positive syndrome, which allows to consider total score on the scale as an indicator of this psychopathological construct severity. On the basis of metric approach, criteria for assessing the severity of positive symptoms in the dynamics of therapy have been developed. Statistically significant linear relationship has been found between the levels of SAPS and CGI scales: SAPS has shown higher discriminativeness in assessing severe levels and less marked discriminativeness in assessing low levels of positive symptoms compared to CGI.
Conclusions. SAPS has acceptable psychometric characteristics. The developed diagnostic criteria are suitable for the use in clinical practice and research.
Key words: positive symptoms, schizophrenia, psychometric properties, Rasch measurement, index of minimal detectable changes, Clinical Global Impression Scale.
References
1. Overall JE, Gorham DR. The brief psychiatric rating scale. Psychol Rep. 1962 Jun;10(3):799-812. doi: http://dx.doi.org/10.2466/pr0.1962.10.3.799
2. Krawiecka M, Goldberg D, Vaughan M. A standardized psychiatric assessment scale for rating chronic psychotic patients. Acta Psychiatr Scand. 1977 Apr;55(4):299-308. doi: http://dx.doi.org/10.1111/j.1600-0447.1977.tb00174.x
3. Andreasen NC. The scale for the assessment of positive symptoms (SAPS). Iowa City: University of Iowa; 1984.
4. Mosolov SN. Scales of psychometric assessment of schizophrenia symptomatology and the concept of positive and negative disorders. Moscow, RF; 2001. 238 р. (In Russ.)
5. Kay SR, Opler LA, Lindenmayer J-P. Reliability and validity of the positive and negative syndrome scale for schizophrenics. Psychiatry Res. 1988 Jan;23(1):99-110. doi: http://dx.doi.org/10.1016/0165-1781(88)90038-8
6. Addington J, Addington D, Maticka-Tyndale E. Cognitive functioning and positive and negative symptoms in schizophrenia. Schizophr Res. 1991 Sep;5(2):123-34. doi: http://dx.doi.org/10.1016/0920-9964(91)90039-t
7. Eisen SV, Ranganathan G, Seal P, Spiro A. Measuring clinically meaningful change following mental health treatment. J Behav Health Serv Res. 2007 Jul;34(3):272-89. doi: http://dx.doi.org/10.1007/s11414-007-9066-2
8. Rai SK, Yazdany J, Fortin PR, Aviña-Zubieta JA Approaches for estimating minimal clinically important differences in systemic lupus erythematosus. Arthritis Res Ther. 2015 Jun;17(1):143-150. doi: http://dx.doi.org/10.1186/s13075-015-0658-6
9. Boone WJ. Rasch analysis for instrument development: why, when, and how? CBE Life Sci Educ. 2016;15(4):rm4.1-4.7. doi: http://dx.doi.org/10.1187/cbe.16-04-0148.
10. Assanovich MA. Method for determining threshold criteria in clinical rating scales based on the Rasch model. Psikhiatriia Psikhofarmakoterapiia. 2017;19(3):19-24. (In Russ.)
11. Busner J, Targum SD. The Clinical Global Impressions Scale: applying a research tool in clinical practice. Psychiatry (Edgmont). 2007 Jul;4(7):28-37.
Information about authors:
Assanovich M.V. – senior lecturer of the Chair of Psychiatry and Narcology, Grodno State Medical University,
ORCID: https://orcid.org/0000-0002-7379-6236
Correspondence address: Republic of Belarus, 230009, Grodno, 15/1 Obukhov str., Grodno State Medical University, Chair of Psychiatry and Narcology. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Marina V. Assanovich.