TY - JOUR
T1 - Identifying clinically meaningful symptom response cut-off values on the SANS in predominant negative symptoms
AU - Levine, Stephen Z.
AU - Leucht, Stefan
N1 - Funding Information: In the last three years Stefan Leucht received speaker/consultancy/advisory board honoraria from SanofiAventis, BMS, Alkermes, Eli Lilly, Essex Pharma, AstraZeneca, Janssen/Johnson and Johnson, Lundbeck, Lundbeck Institute, Medavante and Pfizer. Eli Lilly provided medication for a clinical trial with Stefan Leucht as the principal investigator. Stefan Leucht received funding from the German Ministry of Education and Research for a clinical trial and systematic reviews. The American College of Neuropsychopharmacology has provided a travel grant to attend the ACNP meeting in 2010. Stephen Levine has received research support, and/or consultancy fees and/or travel support from F. Hoffmann-La Roche and Eli Lilly.
PY - 2013/4
Y1 - 2013/4
N2 - Background: The treatment and measurement of negative symptoms are currently at issue in schizophrenia, but the clinical meaning of symptom severity and change is unclear. Aim: To offer a clinically meaningful interpretation of severity and change scores on the Scale for the Assessment of Negative Symptoms (SANS). Method: Patients were intention-to-treat participants (n=383) in two double-blind randomized placebo-controlled clinical trials that compared amisulpride with placebo for the treatment of predominant negative symptoms. Equipercentile linking was used to examine extrapolation from (a) CGI-S to SANS severity ratings, and (b) CGI-I to SANS percentage change (n=383). Linking was conducted at baseline, 8-14. days, 28-30. days, and 56-60. days of the trials. Results: Across visits, CGI-S ratings of 'not ill' linked to SANS scores of 0-13, and ranged to 'extreme' ratings that linked to SANS scores of 102-105. The relationship between the CGI-S and the SANS severity scores assumed a linear trend (1=0-13, 2=15-56, 3=37-61, 4=49-66, 5=63-75, 6=79-89, 7=102-105). Similarly the relationship between CGI-I ratings and SANS percentage change followed a linear trend. For instance, CGI-I ratings of 'very much improved' were linked to SANS percent changes of 90 to 67, 'much improved' to 50 to 42, and 'minimally improved' to 21 to 13. Conclusions: The current results uniquely contribute to the debate surrounding negative symptoms by providing clinical meaning to SANS severity and change scores and so offer direction regarding clinically meaningful response cut-off scores to guide treatment targets of predominant negative symptoms.
AB - Background: The treatment and measurement of negative symptoms are currently at issue in schizophrenia, but the clinical meaning of symptom severity and change is unclear. Aim: To offer a clinically meaningful interpretation of severity and change scores on the Scale for the Assessment of Negative Symptoms (SANS). Method: Patients were intention-to-treat participants (n=383) in two double-blind randomized placebo-controlled clinical trials that compared amisulpride with placebo for the treatment of predominant negative symptoms. Equipercentile linking was used to examine extrapolation from (a) CGI-S to SANS severity ratings, and (b) CGI-I to SANS percentage change (n=383). Linking was conducted at baseline, 8-14. days, 28-30. days, and 56-60. days of the trials. Results: Across visits, CGI-S ratings of 'not ill' linked to SANS scores of 0-13, and ranged to 'extreme' ratings that linked to SANS scores of 102-105. The relationship between the CGI-S and the SANS severity scores assumed a linear trend (1=0-13, 2=15-56, 3=37-61, 4=49-66, 5=63-75, 6=79-89, 7=102-105). Similarly the relationship between CGI-I ratings and SANS percentage change followed a linear trend. For instance, CGI-I ratings of 'very much improved' were linked to SANS percent changes of 90 to 67, 'much improved' to 50 to 42, and 'minimally improved' to 21 to 13. Conclusions: The current results uniquely contribute to the debate surrounding negative symptoms by providing clinical meaning to SANS severity and change scores and so offer direction regarding clinically meaningful response cut-off scores to guide treatment targets of predominant negative symptoms.
KW - Negative symptoms
KW - Schizophrenia
KW - Severity of Illness Index
KW - Treatment response
UR - http://www.scopus.com/inward/record.url?scp=84875243584&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.schres.2012.12.032
DO - https://doi.org/10.1016/j.schres.2012.12.032
M3 - مقالة
C2 - 23394742
SN - 0920-9964
VL - 145
SP - 125
EP - 127
JO - Schizophrenia Research
JF - Schizophrenia Research
IS - 1-3
ER -
