Replicating and Extending the Reliability, Criterion Validity, and Treatment Sensitivity of the PANSS10 and PANSS20 for Pediatric Trials.

Objective: Pediatric studies of schizophrenia have relied on the 30-item Positive and Negative Syndrome Scale (PANSS30) as a primary outcome measure. There have been many efforts to create shorter versions of it to reduce costs and burden. The present aim is to conduct a confirmatory investigation of the reliability and validity of 10- and 20-item abbreviated versions developed in a United States-based National Institute of Mental Health (NIMH) pediatric sample that reflects the 5-factor structure underlying the PANSS, adding more detailed examination of patient-level score reproducibility and extending the examination to a large, placebo-controlled, international pediatric trial. Method: We applied the same psychometric and treatment sensitivity analyses as in Findling Results: Using the paliperidone RCT dataset, with N = 201 participants between the ages of 12 and 17 years (mean age = 15.40, SD = 1.53 years; 59% male), the PANSS 10- or 20-item vs 30-item versions had similar average interitem correlations (0.11-0.15); ω Conclusion: Results replicated reliability and validity findings for the PANSS10 and PANSS20 short forms in an international pediatric randomized placebo-controlled trial. Findings extend prior work by being the first to apply modern reliability models (ω) for multi-factor composites, also using Bland-Altman methods to evaluate patient-level score reproducibility. Scores based on the PANSS10 or PANSS20 reproduce traditional scores with high fidelity and low bias, offering substantial savings in terms of time, cost, and burden, especially when used for tracking progress or outcomes. Clinical guidance: • Consider using the 10-item or 20-item PANSS for regular monitoring and assessment of pediatric schizophrenia patients. These shorter versions maintain high reliability and can streamline the evaluation process, making it more efficient.• Patient and family engagement: Use the abbreviated PANSS versions to engage more effectively with patients and their families. The reduced length of the assessment can alleviate the stress and fatigue associated with longer evaluations, potentially improving patient cooperation and the quality of the data collected.