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ArticleJournal of autism and developmental disorders2026

What Does the PANSS Autism Severity Score (PAUSS) Really Measure in Patients With First Episode Psychosis? Critical Considerations.

Lorenzo Pelizza, Antonio Federico, Emanuela Leuci, Emanuela Quattrone, Derna Palmisano, Simona Pupo, Giuseppina Paulillo, Clara Pellegrini, Pietro Pellegrini, Marco Menchetti

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Article in Journal of autism and developmental disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Lorenzo PelizzaDepartment of Biomedical and Neuromotor Sciences, Istituto di Psichiatria Paolo Ottonello, Alma Mater Studiorum - Università di Bologna, via Pepoli, 5, 40126, Bologna, BO, Italy. lorenzo.pelizza@unibo.it.ORCID http://orcid.org/0000-0003-4746-2061
Antonio FedericoDepartment of Biomedical and Neuromotor Sciences, Istituto di Psichiatria Paolo Ottonello, Alma Mater Studiorum - Università di Bologna, via Pepoli, 5, 40126, Bologna, BO, Italy.
Emanuela LeuciDepartment of Mental Health and Pathological Addiction, Azienda USL di Parma, Università di Parma, Parma, PR, Italy.
Emanuela QuattroneDepartment of Mental Health and Pathological Addiction, Azienda USL di Parma, Università di Parma, Parma, PR, Italy.
Derna PalmisanoDepartment of Mental Health and Pathological Addiction, Azienda USL di Parma, Università di Parma, Parma, PR, Italy.
Simona PupoPain Therapy Service, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Parma, PR, Italy.
Giuseppina PaulilloDepartment of Mental Health and Pathological Addiction, Azienda USL di Parma, Università di Parma, Parma, PR, Italy.
Clara PellegriniDepartment of Mental Health and Pathological Addiction, Azienda USL di Parma, Università di Parma, Parma, PR, Italy.
Pietro PellegriniDepartment of Mental Health and Pathological Addiction, Azienda USL di Parma, Università di Parma, Parma, PR, Italy.
Marco MenchettiDepartment of Biomedical and Neuromotor Sciences, Istituto di Psichiatria Paolo Ottonello, Alma Mater Studiorum - Università di Bologna, via Pepoli, 5, 40126, Bologna, BO, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe PANSS Autism Severity Score (PAUSS) has recently become a popular measure of autistic features in psychosis populations, but evidence on its longitudinal reliability and factor configuration is poor. The aims of this investigation were to examine psychometric characteristics of the PAUSS in young patients with First Episode Psychosis (FEP) treated in an early intervention service, with primary interest for its long-term stability across 2 years of follow-up and factor configuration.

methodsAll FEP participants completed the Positive And Negative Syndrome Scale (PANSS) and Autism Quotient (AQ) at baseline and across the follow-up. Statistical analysis mainly included Cronbach's α to examine internal consistency of the PAUSS, Cohen's k statistics and Spearman's ρ correlation coefficients for its longitudinal stability and convergent validity with AQ scores, and exploratory factor analysis to explore its dimensions' configuration.

results301 FEP participants were recruited (170 with Schizophrenia Spectrum Disorder [SSD]). Cronbach's α value for the PAUSS was 0.806, but with unacceptable inter-item correlations for PANSS G5 and G15 items. K value for examining PAUSS convergent validity with AQ score was unacceptable (0.295), as well as ρ and k values to quantify long-term test-retest reliability (< 0.750 and < 0.600, respectively). No long-term stability of the PAUSS scores across the follow-up was also found using Wilcoxon's test for repeated measure. Our EFA found a 2-factor model in the FEP total sample and a 3-factor configuration in the SSD subgroup.

conclusionOur results suggest that the PAUSS does not represent a valid instrument to assess autistic features in FEP and SSD. Indeed, the it probably captures psychotic symptom severity rather than autistic features, especially reflecting negative symptom load.

Indexed as

Autism spectrum disorders; first episode psychosisPANSSPAUSSPsychometric propertiesSchizophrenia

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