The Positive and Negative Syndrome Scale (PANSS): Rationale and Standardisation

Over 75 years ago, Bleuler (1911) confronted psychiatry with the question of ‘schizophrenia’ or ‘schizophrenias'. Today we recognise the heterogeneity of the condition, but we are still groping at efforts to clarify the different subtypes or subprocesses. Over the decades there have been various attempts to subclassify schizophrenia and tease apart the syndromes, none of which has been entirely successful. More recently, as a result of the work by Crow (1980) in England and Strauss et al (1974) in the USA, it has been proposed that two distinct syndromes can be discerned from the phenomenological profiles. The positive syndrome consists of productive features superadded to the mental status, such as delusions, hallucinations, and disorganised thinking. The negative syndrome represents absence of normal functions, such as deficits in the cognitive, affective, and social realms.