Evidence-based assessment of schizophrenia

[psychgirl77]

Can anyone point me in the direction of good evidence-based assessment measures for schizophrenia? I know that the SADS (Schedule for Affective Disorders and Schizophrenia) is one, but what are some other good measures? Thanks!

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[erg923]

Honestly, the best assessment for diagnosing schizophrenia is simply a good, very thorough clinical interview and history. Any good clinician should be able to pick it up. Once the diagnosis is established however, using ratings scales to track severity of symptoms may be useful. I would suggest either the BPRS or the PANSS.

 

[thewesternsky]

Diagnostic interviews are the best tools, as Erg pointed out. There are some nice structured ones out there (e.g., the SCID). The MINI is another, especially useful for research purposes... It's shorter and can be useful, though it's new and still undergoing revision.

 

[erg923]

Ive done about 50 SCIDs while in grad school...half of therm were on individuals with questions of a psychotic illness/history. Frankly, I get more useful info from the overview section of it than I do from module B. Well, maybe thats an exaggeration, but I do still find the psychotic section (module B) to be rather limited. I also never utilize module C (the psychotic differentials section). I just go though the DSM after the interview.

 

[robinsena]

I would say that there are good clinicians who may have a hard time diagnosing some psychotic disorders, especially differentiating schizoaffective and schizophrenia with depression, so I'm not sure a good clinician can always pick up the exact diagnosis with a thorough interview. Many SMI clients also have cognitive deficits which will make completing an accurate timeline of their psychiatric history difficult, if not impossible.

I personally like the PANSS but it depends on what kind of assessment you need, and for what purpose.

 

[psychgirl77]

Thanks for your help everyone! I'm looking for more of a diagnostic rather than symptom severity measure so I'll take a look at some of the things you all mentioned.

 

[erg923]

There's the MMPI-2 of course, but its so confounded (scale 8 elevations can mean alot of things) and you have to look at BIZ-I and BIZ-II, check Harris-Lingoes, etc. Not sure its very solid for really diagnosing, most likely only affirming strong suspicions from an interview.

 

[AcronymAllergy]

There's the MMPI-2 of course, but its so confounded (scale 8 elevations can mean alot of things) and you have to look at BIZ-I and BIZ-II, check Harris-Lingoes, etc. Not sure its very solid for really diagnosing, most likely only affirming strong suspicions from an interview.

The RF is supposed to add a lot more clarity and intuitiveness to the scoring and interpretation processes, but I haven't personally used one yet, so I can't say if that's actually the case.

They did give an excellent presentation on it at NAN, though.

 

[erg923]

I have switched over to utilizing the RC scales for interpretation, but no site I know of around here utilizes, or even has the RF yet.....

 

[AcronymAllergy]

I have switched over to utilizing the RC scales for interpretation, but no site I know of around here utilizes, or even has the RF yet.....

I'd never seen one myself until that presentation, honestly.

 

[Therapist4Chnge]

Here is another vote for a solid clinical interview.

 

[axisone]

The PANSS is a good interview that isn't as long as the SCID, and you have the benefit of not going through SCID training. There are also ways to take the interview from PANSS and fill out rating scales like the BPRS, SAPS and SANS with a few modifications to the interview.