Staging of Schizophrenia with the Use of PANSS: An International Multi-Center Study

Konstantinos N. Fountoulakis; Elena Dragioti; Antonis T. Theofilidis; Tobias Wikilund; Xenofon Atmatzidis; Ioannis Nimatoudis; Erik Thys; Martien Wampers; Luchezar Hranov; Trayana Hristova; Daniil Aptalidis; Roumen Milev; Felicia Iftene; Filip Spaniel; Pavel Knytl; Petra Furstova; Tiina From; Henry Karlsson; Maija Walta; Raimo K.R. Salokangas; Jean Michel Azorin; Justine Bouniard; Julie Montant; Georg Juckel; Ida S. Haussleiter; Athanasios Douzenis; Ioannis Michopoulos; Panagiotis Ferentinos; Nikolaos Smyrnis; Leonidas Mantonakis; Zsófia Nemes; Xenia Gonda; Dora Vajda; Anita Juhasz; Amresh Shrivastava; John Waddington; Maurizio Pompili; Anna Comparelli; Valentina Corigliano; Elmars Rancans; Alvydas Navickas; Jan Hilbig; Laurynas Bukelskis; Lidija Injac Stevovic; Sanja Vodopic; Oluyomi Esan; Oluremi Oladele; Christopher Osunbote; Janusz Rybakowski; Pawel Wojciak; Klaudia Domowicz; Maria Luisa Figueira; Ludgero Linhares; Joana Crawford; Anca Livia Panfil; Daria Smirnova; Olga Izmailova; Dusica Lecic-Tosevski; Henk Temmingh; Fleur Howells; Julio Bobes; Maria Paz Garcia-Portilla; Leticia García-Alvarez; Gamze Erzin; Hasan Karadaǧ; Avinash De Sousa; Anuja Bendre; Cyril Hoschl; Cristina Bredicean; Ion Papava; Olivera Vukovic; Bojana Pejuskovic; Vincent Russell; Loukas Athanasiadis; Anastasia Konsta; Dan Stein; Michael Berk; Olivia Dean; Rajiv Tandon; Siegfried Kasper; Marc De Hert

doi:10.1093/ijnp/pyz053

Staging of Schizophrenia with the Use of PANSS: An International Multi-Center Study

Konstantinos N. Fountoulakis^*, Elena Dragioti, Antonis T. Theofilidis, Tobias Wikilund, Xenofon Atmatzidis, Ioannis Nimatoudis, Erik Thys, Martien Wampers, Luchezar Hranov, Trayana Hristova, Daniil Aptalidis, Roumen Milev, Felicia Iftene, Filip Spaniel, Pavel Knytl, Petra Furstova, Tiina From, Henry Karlsson, Maija Walta, Raimo K.R. SalokangasJean Michel Azorin, Justine Bouniard, Julie Montant, Georg Juckel, Ida S. Haussleiter, Athanasios Douzenis, Ioannis Michopoulos, Panagiotis Ferentinos, Nikolaos Smyrnis, Leonidas Mantonakis, Zsófia Nemes, Xenia Gonda, Dora Vajda, Anita Juhasz, Amresh Shrivastava, John Waddington, Maurizio Pompili, Anna Comparelli, Valentina Corigliano, Elmars Rancans, Alvydas Navickas, Jan Hilbig, Laurynas Bukelskis, Lidija Injac Stevovic, Sanja Vodopic, Oluyomi Esan, Oluremi Oladele, Christopher Osunbote, Janusz Rybakowski, Pawel Wojciak, Klaudia Domowicz, Maria Luisa Figueira, Ludgero Linhares, Joana Crawford, Anca Livia Panfil, Daria Smirnova, Olga Izmailova, Dusica Lecic-Tosevski, Henk Temmingh, Fleur Howells, Julio Bobes, Maria Paz Garcia-Portilla, Leticia García-Alvarez, Gamze Erzin, Hasan Karadaǧ, Avinash De Sousa, Anuja Bendre, Cyril Hoschl, Cristina Bredicean, Ion Papava, Olivera Vukovic, Bojana Pejuskovic, Vincent Russell, Loukas Athanasiadis, Anastasia Konsta, Dan Stein, Michael Berk, Olivia Dean, Rajiv Tandon, Siegfried Kasper, Marc De Hert

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

45 Scopus citations

Abstract

Introduction: A 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. Methods: Twenty-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. Results: Exploratory 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.

Original language	English
Pages (from-to)	681-697
Number of pages	17
Journal	International Journal of Neuropsychopharmacology
Volume	22
Issue number	11
DOIs	https://doi.org/10.1093/ijnp/pyz053
State	Published - 30 Sep 2019
Externally published	Yes

Funding

Funders	Funder number
National Health and Medical Research Council	APP1156072, APP1059660

Keywords

illness course
outcome
schizophrenia
staging

Access to Document

10.1093/ijnp/pyz053

Cite this

Fountoulakis, K. N., Dragioti, E., Theofilidis, A. T., Wikilund, T., Atmatzidis, X., Nimatoudis, I., Thys, E., Wampers, M., Hranov, L., Hristova, T., Aptalidis, D., Milev, R., Iftene, F., Spaniel, F., Knytl, P., Furstova, P., From, T., Karlsson, H., Walta, M., ... De Hert, M. (2019). Staging of Schizophrenia with the Use of PANSS: An International Multi-Center Study. International Journal of Neuropsychopharmacology, 22(11), 681-697. https://doi.org/10.1093/ijnp/pyz053

@article{aae02b29cc004749ad143503eaba9af7,

title = "Staging of Schizophrenia with the Use of PANSS: An International Multi-Center Study",

abstract = "Introduction: A 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. Methods: Twenty-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. Results: Exploratory 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.",

keywords = "illness course, outcome, schizophrenia, staging",

author = "Fountoulakis, {Konstantinos N.} and Elena Dragioti and Theofilidis, {Antonis T.} and Tobias Wikilund and Xenofon Atmatzidis and Ioannis Nimatoudis and Erik Thys and Martien Wampers and Luchezar Hranov and Trayana Hristova and Daniil Aptalidis and Roumen Milev and Felicia Iftene and Filip Spaniel and Pavel Knytl and Petra Furstova and Tiina From and Henry Karlsson and Maija Walta and Salokangas, {Raimo K.R.} and Azorin, {Jean Michel} and Justine Bouniard and Julie Montant and Georg Juckel and Haussleiter, {Ida S.} and Athanasios Douzenis and Ioannis Michopoulos and Panagiotis Ferentinos and Nikolaos Smyrnis and Leonidas Mantonakis and Zs{\'o}fia Nemes and Xenia Gonda and Dora Vajda and Anita Juhasz and Amresh Shrivastava and John Waddington and Maurizio Pompili and Anna Comparelli and Valentina Corigliano and Elmars Rancans and Alvydas Navickas and Jan Hilbig and Laurynas Bukelskis and {Injac Stevovic}, Lidija and Sanja Vodopic and Oluyomi Esan and Oluremi Oladele and Christopher Osunbote and Janusz Rybakowski and Pawel Wojciak and Klaudia Domowicz and Figueira, {Maria Luisa} and Ludgero Linhares and Joana Crawford and Panfil, {Anca Livia} and Daria Smirnova and Olga Izmailova and Dusica Lecic-Tosevski and Henk Temmingh and Fleur Howells and Julio Bobes and Garcia-Portilla, {Maria Paz} and Leticia Garc{\'i}a-Alvarez and Gamze Erzin and Hasan Karadaǧ and {De Sousa}, Avinash and Anuja Bendre and Cyril Hoschl and Cristina Bredicean and Ion Papava and Olivera Vukovic and Bojana Pejuskovic and Vincent Russell and Loukas Athanasiadis and Anastasia Konsta and Dan Stein and Michael Berk and Olivia Dean and Rajiv Tandon and Siegfried Kasper and {De Hert}, Marc",

note = "Publisher Copyright: {\textcopyright} 2019 The Author(s) 2019. Published by Oxford University Press on behalf of CINP.",

year = "2019",

month = sep,

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doi = "10.1093/ijnp/pyz053",

language = "אנגלית",

volume = "22",

pages = "681--697",

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Fountoulakis, KN, Dragioti, E, Theofilidis, AT, Wikilund, T, Atmatzidis, X, Nimatoudis, I, Thys, E, Wampers, M, Hranov, L, Hristova, T, Aptalidis, D, Milev, R, Iftene, F, Spaniel, F, Knytl, P, Furstova, P, From, T, Karlsson, H, Walta, M, Salokangas, RKR, Azorin, JM, Bouniard, J, Montant, J, Juckel, G, Haussleiter, IS, Douzenis, A, Michopoulos, I, Ferentinos, P, Smyrnis, N, Mantonakis, L, Nemes, Z, Gonda, X, Vajda, D, Juhasz, A, Shrivastava, A, Waddington, J, Pompili, M, Comparelli, A, Corigliano, V, Rancans, E, Navickas, A, Hilbig, J, Bukelskis, L, Injac Stevovic, L, Vodopic, S, Esan, O, Oladele, O, Osunbote, C, Rybakowski, J, Wojciak, P, Domowicz, K, Figueira, ML, Linhares, L, Crawford, J, Panfil, AL, Smirnova, D, Izmailova, O, Lecic-Tosevski, D, Temmingh, H, Howells, F, Bobes, J, Garcia-Portilla, MP, García-Alvarez, L, Erzin, G, Karadaǧ, H, De Sousa, A, Bendre, A, Hoschl, C, Bredicean, C, Papava, I, Vukovic, O, Pejuskovic, B, Russell, V, Athanasiadis, L, Konsta, A, Stein, D, Berk, M, Dean, O, Tandon, R, Kasper, S & De Hert, M 2019, 'Staging of Schizophrenia with the Use of PANSS: An International Multi-Center Study', International Journal of Neuropsychopharmacology, vol. 22, no. 11, pp. 681-697. https://doi.org/10.1093/ijnp/pyz053

TY - JOUR

T1 - Staging of Schizophrenia with the Use of PANSS

T2 - An International Multi-Center Study

AU - Fountoulakis, Konstantinos N.

AU - Dragioti, Elena

AU - Theofilidis, Antonis T.

AU - Wikilund, Tobias

AU - Atmatzidis, Xenofon

AU - Nimatoudis, Ioannis

AU - Thys, Erik

AU - Wampers, Martien

AU - Hranov, Luchezar

AU - Hristova, Trayana

AU - Aptalidis, Daniil

AU - Milev, Roumen

AU - Iftene, Felicia

AU - Spaniel, Filip

AU - Knytl, Pavel

AU - Furstova, Petra

AU - From, Tiina

AU - Karlsson, Henry

AU - Walta, Maija

AU - Salokangas, Raimo K.R.

AU - Azorin, Jean Michel

AU - Bouniard, Justine

AU - Montant, Julie

AU - Juckel, Georg

AU - Haussleiter, Ida S.

AU - Douzenis, Athanasios

AU - Michopoulos, Ioannis

AU - Ferentinos, Panagiotis

AU - Smyrnis, Nikolaos

AU - Mantonakis, Leonidas

AU - Nemes, Zsófia

AU - Gonda, Xenia

AU - Vajda, Dora

AU - Juhasz, Anita

AU - Shrivastava, Amresh

AU - Waddington, John

AU - Pompili, Maurizio

AU - Comparelli, Anna

AU - Corigliano, Valentina

AU - Rancans, Elmars

AU - Navickas, Alvydas

AU - Hilbig, Jan

AU - Bukelskis, Laurynas

AU - Injac Stevovic, Lidija

AU - Vodopic, Sanja

AU - Esan, Oluyomi

AU - Oladele, Oluremi

AU - Osunbote, Christopher

AU - Rybakowski, Janusz

AU - Wojciak, Pawel

AU - Domowicz, Klaudia

AU - Figueira, Maria Luisa

AU - Linhares, Ludgero

AU - Crawford, Joana

AU - Panfil, Anca Livia

AU - Smirnova, Daria

AU - Izmailova, Olga

AU - Lecic-Tosevski, Dusica

AU - Temmingh, Henk

AU - Howells, Fleur

AU - Bobes, Julio

AU - Garcia-Portilla, Maria Paz

AU - García-Alvarez, Leticia

AU - Erzin, Gamze

AU - Karadaǧ, Hasan

AU - De Sousa, Avinash

AU - Bendre, Anuja

AU - Hoschl, Cyril

AU - Bredicean, Cristina

AU - Papava, Ion

AU - Vukovic, Olivera

AU - Pejuskovic, Bojana

AU - Russell, Vincent

AU - Athanasiadis, Loukas

AU - Konsta, Anastasia

AU - Stein, Dan

AU - Berk, Michael

AU - Dean, Olivia

AU - Tandon, Rajiv

AU - Kasper, Siegfried

AU - De Hert, Marc

PY - 2019/9/30

Y1 - 2019/9/30

N2 - Introduction: A 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. Methods: Twenty-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. Results: Exploratory 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.

AB - Introduction: A 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. Methods: Twenty-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. Results: Exploratory 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.

KW - illness course

KW - outcome

KW - schizophrenia

KW - staging

UR - http://www.scopus.com/inward/record.url?scp=85075813327&partnerID=8YFLogxK

U2 - 10.1093/ijnp/pyz053

DO - 10.1093/ijnp/pyz053

M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???

C2 - 31563956

AN - SCOPUS:85075813327

SN - 1461-1457

VL - 22

SP - 681

EP - 697

JO - International Journal of Neuropsychopharmacology

JF - International Journal of Neuropsychopharmacology

IS - 11

ER -

Staging of Schizophrenia with the Use of PANSS: An International Multi-Center Study

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