ArticleThe international journal of neuropsychopharmacology2019
Staging of Schizophrenia With the Use of PANSS: An International Multi-Center Study.
Open access · goldAbstract readMulticenter Study
In one paragraph
Article in The international journal of neuropsychopharmacology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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20citing papers in PubMed, 2 pooled it
4.8field-weighted citation impact, top 4% of its field
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The trial behind it
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- The progress in the field of clinical staging for mental disorders within the last decade: an updated systematic review.Frontiers in psychiatry · 2024Pooled it
- Is it possible to stage schizophrenia? A systematic review.Translational psychiatry · 2022Pooled it
- Comparing the latent state-trait structure of the PANSS in cariprazine-medicated and placebo-controlled patients with acute schizophrenia.European archives of psychiatry and clinical neuroscience · 2024Trial
- Co-administration of probiotic and vitamin D significantly improves cognitive function in schizophrenic patients: A double-blinded randomized controlled trial.Neuropsychopharmacology reports · 2024Trial
- COSMIN systematic review and meta-analysis of the measurement properties of the Positive and Negative Syndrome Scale (PANSS).EClinicalMedicine · 2025Article
- COSMIN review of the PANSS Marder factor solution and other factor models in people with schizophrenia.Schizophrenia (Heidelberg, Germany) · 2025Article
- Pharmacological Interventions for Negative Symptoms in Schizophrenia: A Systematic Review of Randomised Control Trials.Biomedicines · 2025Review
- Attenuated mental symptoms in the general population: first data from the observational cross-sectional ATTENTION study in Greece.CNS spectrums · 2025Observational
- Article
- Plasma microRNAs Associate Positive, Negative, and Cognitive Symptoms with Inflammation in Schizophrenia.International journal of molecular sciences · 2024Article
- A generalisability theory approach to quantifying changes in psychopathology among ultra-high-risk individuals for psychosis.Schizophrenia (Heidelberg, Germany) · 2024Article
- Circulating microRNA Profiles Identify a Patient Subgroup with High Inflammation and Severe Symptoms in Schizophrenia Experiencing Acute Psychosis.International journal of molecular sciences · 2024Article
- PsiOvi Staging Model for Schizophrenia (PsiOvi SMS): A New Internet Tool for Staging Patients with Schizophrenia.European psychiatry : the journal of the Association of European Psychiatrists · 2024Article
- Correlates of severity in a clinical staging model of schizophrenia: a cross-sectional study among 158 subjects.BMC psychiatry · 2023Article
- Initial response to the COVID-19 pandemic on real-life well-being, social contact and roaming behavior in patients with schizophrenia, major depression and healthy controls: A longitudinal ecological momentary assessment study.European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology · 2023Article
- Positive and negative syndrome scale in forensic patients with schizophrenia spectrum disorders: a systematic review and meta-analysis.Annals of general psychiatry · 2022Review
- Paternal age and specific neurological soft signs as reliable and valid neurobiological markers for the diagnosis of patients with schizophrenia.European archives of psychiatry and clinical neuroscience · 2022Article
- Symptomatic Profile of Cariprazine in the Context of ICD-11 Domains for Schizophrenia: Review of Clinically Oriented Studies: Симптоматический профиль карипразина в контексте доменов шизофрении в МКБ -11: обзор клинически ориентированных исследований.Consortium psychiatricum · 2022Review
- How Attachment Styles Influence Emotional Distress and Psychiatric Symptoms Among Individuals With Schizophrenia: A Cross-Sectional Nursing Survey.SAGE open nursingArticle
- Association of negative symptom domains and other clinical characteristics of schizophrenia on long-term hospitalization.Indian journal of psychiatryArticle
Corrections and comments
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Authors and funding
81 authors at 20 institutions in 28 countries.
Konstantinos N Fountoulakis3rd Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Greece.
Elena DragiotiDepartment of Medical and Health Sciences (IMH), Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Antonis T Theofilidis3rd Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Greece.
Tobias WikilundDepartment of Medical and Health Sciences (IMH), Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Xenofon AtmatzidisDepartment of Medical and Health Sciences (IMH), Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Ioannis Nimatoudis3rd Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Greece.
Erik ThysUniversity Psychiatric Centre KU Leuven, Kortenberg and Department of Neurosciences KU, Leuven, Belgium.
Martien WampersUniversity Psychiatric Centre KU Leuven, Kortenberg and Department of Neurosciences KU, Leuven, Belgium.
Luchezar HranovUniversity Multiprofile Hospital for Active Treatment in Neurology and Psychiatry "Sveti Naum", Sofia, Bulgaria.
Trayana HristovaUniversity Multiprofile Hospital for Active Treatment in Neurology and Psychiatry "Sveti Naum", Sofia, Bulgaria.
Daniil AptalidisUniversity Multiprofile Hospital for Active Treatment in Neurology and Psychiatry "Sveti Naum", Sofia, Bulgaria.
Roumen MilevDepartment of Psychiatry, Queen's University, Providence Care Hospital, Kingston, Ontario, Canada.
Felicia IfteneDepartment of Psychiatry, Queen's University, Providence Care Hospital, Kingston, Ontario, Canada.
Filip SpanielNational Institute of Mental Health, Klecany, Czech Republic.
Pavel KnytlNational Institute of Mental Health, Klecany, Czech Republic.
Petra FurstovaNational Institute of Mental Health, Klecany, Czech Republic.
Tiina FromDepartment of Psychiatry, University of Turku, Turku, Finland.
Henry KarlssonDepartment of Psychiatry, University of Turku, Turku, Finland.
Maija WaltaDepartment of Psychiatry, University of Turku, Turku, Finland.
Raimo K R SalokangasDepartment of Psychiatry, University of Turku, Turku, Finland.
Jean-Michel AzorinDepartment of Psychiatry, Sainte Marguerite University Hospital, Marseille, France.
Justine BouniardDepartment of Psychiatry, Sainte Marguerite University Hospital, Marseille, France.
Julie MontantDepartment of Psychiatry, Sainte Marguerite University Hospital, Marseille, France.
Georg JuckelDepartment of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany.
Ida S HaussleiterDepartment of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany.
Athanasios Douzenis2nd Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece.
Ioannis Michopoulos2nd Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece.
Panagiotis Ferentinos2nd Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece.
Nikolaos SmyrnisDepartment of Psychiatry, National and Kapodistrian University of Athens School of Medicine, Eginition Hospital, Athens, Greece.
Leonidas MantonakisDepartment of Psychiatry, National and Kapodistrian University of Athens School of Medicine, Eginition Hospital, Athens, Greece.
Zsófia NemesNyírő Gyula Hospital, Budapest, Hungary.
Xenia GondaDepartment of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
Dora VajdaDepartment of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
Anita JuhaszDepartment of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
Amresh ShrivastavaWestern University, London Ontario, Canada.
John WaddingtonMolecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.
Maurizio PompiliDepartment of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
Anna ComparelliDepartment of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
Valentina CoriglianoDepartment of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
Elmars RancansDepartment of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia.
Alvydas NavickasClinic of Psychiatric, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Jan HilbigClinic of Psychiatric, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Laurynas BukelskisClinic of Psychiatric, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Lidija Injac StevovicClinical Department of Psychiatry, Clinical Centre of Montenegro, Podgorica, Montenegro.
Sanja VodopicClinical Department of Psychiatry, Clinical Centre of Montenegro, Podgorica, Montenegro.
Oluyomi EsanDepartment of Psychiatry, College of Medicine, University of Ibadan, Nigeria.
Oluremi OladeleDepartment of Psychiatry, College of Medicine, University of Ibadan, Nigeria.
Christopher OsunboteDepartment of Psychiatry, College of Medicine, University of Ibadan, Nigeria.
Janusz Κ RybakowskiDepartment of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland.
Pawel WojciakDepartment of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland.
Klaudia DomowiczDepartment of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland.
Maria Luisa FigueiraDepartment of Psychiatry and Mental Health, Santa Maria University Hospital, Lisbon, Portugal.
Ludgero LinharesDepartment of Psychiatry and Mental Health, Santa Maria University Hospital, Lisbon, Portugal.
Joana CrawfordDepartment of Psychiatry and Mental Health, Santa Maria University Hospital, Lisbon, Portugal.
Anca-Livia PanfilUniversity of Medicine and Pharmacy of Târgu Mures, Romania.
Daria SmirnovaSamara State Medical University, Department of Psychiatry, Samara Psychiatric Hospital, Inpatient Unit, Russia.
Olga IzmailovaSamara State Medical University, Department of Psychiatry, Samara Psychiatric Hospital, Inpatient Unit, Russia.
Dusica Lecic-TosevskiInstitute of Mental Health, Belgrade, Serbia.
Henk TemminghDepartment of Psychiatry and Mental Health, University of Cape Town Cape Town, Western Cape, South Africa.
Fleur HowellsDepartment of Psychiatry and Mental Health, University of Cape Town Cape Town, Western Cape, South Africa.
Julio BobesDepartment of Psychiatry, University of Oviedo and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain.
Maria Paz Garcia-PortillaDepartment of Psychiatry, University of Oviedo and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain.
Leticia García-AlvarezDepartment of Psychiatry, University of Oviedo and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain.
Gamze ErzinPsychiatry Department, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
Hasan KaradağPsychiatry Department, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
Avinash De SousaDepartment of Psychiatry Lokmanya Tilak Municipal Medical College Mumbai, India.
Anuja BendreDepartment of Psychiatry Lokmanya Tilak Municipal Medical College Mumbai, India.
Cyril HoschlNational Institute of Mental Health, Klecany, Czech Republic.
Cristina BrediceanUniversity of Medicine and Pharmacy of Timisoara, Romania.
Ion PapavaUniversity of Medicine and Pharmacy of Timisoara, Romania.
Olivera VukovicInstitute of Mental Health, School of Medicine, University of Belgrade, Belgrade, Serbia.
Bojana PejuskovicDepartment of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
Vincent RussellDepartment of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
Loukas Athanasiadis1st Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Greece.
Anastasia Konsta1st Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Greece.
Dan SteinMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
Michael BerkDeakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia.
Olivia DeanDeakin University, School of Medicine, IMPACT Strategic Research Centre, Barwon Health, Geelong, Australia.
Rajiv TandonDepartment of Psychiatry, University of Florida, ***, FL.
Siegfried KasperDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
Marc De HertUniversity Psychiatric Centre KU Leuven, Kortenberg and Department of Neurosciences KU, Leuven, Belgium.
Aristotle University of Thessaloniki · GRNational and Kapodistrian University of Athens · GRNational Institute of Mental Health · CZUniversity of Turku · FICentre National de la Recherche Scientifique · FRHospital de Santa Maria · PTKU Leuven · BELinköping University · SEMultiprofile Hospital for Active Treatment in Neurology and Psychiatry St. Naum · BGPoznan University of Medical Sciences · PLRoyal College of Surgeons in Ireland · IESapienza University of Rome · ITSemmelweis University · HUUniversidad de Oviedo · ESUniversity of Cape Town · ZAUniversity of Ibadan · NGVilnius University · LTBarwon Health · AUDışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi · TRLokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College · IN
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionA specific clinically relevant staging model for schizophrenia has not yet been developed. The aim of the current study was to evaluate the factor structure of the PANSS and develop such a staging method.
methodsTwenty-nine centers from 25 countries contributed 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Analysis of covariance, Exploratory Factor Analysis, Discriminant Function Analysis, and inspection of resultant plots were performed.
resultsExploratory Factor Analysis returned 5 factors explaining 59% of the variance (positive, negative, excitement/hostility, depression/anxiety, and neurocognition). The staging model included 4 main stages with substages that were predominantly characterized by a single domain of symptoms (stage 1: positive; stages 2a and 2b: excitement/hostility; stage 3a and 3b: depression/anxiety; stage 4a and 4b: neurocognition). There were no differences between sexes. The Discriminant Function Analysis developed an algorithm that correctly classified >85% of patients. DISCUSSION: This study elaborates a 5-factor solution and a clinical staging method for patients with schizophrenia. It is the largest study to address these issues among patients who are more likely to remain affiliated with mental health services for prolonged periods of time.
Indexed as
Disease ProgressionAdultEuropeFactor Analysis, StatisticalFemaleHumansMaleMiddle AgedNigeriaPsychiatric Status Rating ScalesSchizophreniaSotos SyndromeYoung Adultillness courseoutcomeschizophreniastaging
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