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ABSTRACT: Symptom control by drug treatment is the most important task in routine clinical care of patients with schizophrenia. Structured assessment methods are needed in this task but not used much. The US-developed Positive and Negative Syndrome Scale (PANSS) is a standard tool for symptom assessment. The Psychosis Evaluation tool for Common use by Caregivers (PECC) was constructed in Europe some years ago, with the intent to overcome some of the PANSS drawbacks.
To validate PECC on three longitudinal cohorts of schizophrenic patients representative of Swedish outpatients (n = 225, six assessments over 5 years), international forensic patients (n = 186) and matched non-forensic controls (n = 116), five assessments over 2 years for both.
The factor structure of PECC appears to be highly robust. Norm values (in percentiles) were calculated on the materials. Such data provides for analyses of symptom profiles and improvement over time measured in absolute numbers. Forensic patients appear to have a much lower symptom load (except for cognitive symptoms) than the other groups. Forensic controls had much shorter inpatient times than any other group and never caught up with respect to symptom control, even after 2 years. These differences suggest that the scale is clinically valid.
PECC has a more robust factor structure than PANSS and is simpler to use. Percentile norms have been constructed for outpatients with schizophrenia in general and forensic psychiatry. Percentile scores are accessed readily by the net. PECC is available in many languages. Its separate self-harm item may improve assessments of suicide risk among patients with schizophrenia.
Nordic journal of psychiatry 09/2011; 66(1):33-9. · 0.99 Impact Factor
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ABSTRACT: There is a need for an observation scale for assessment and monitoring of acutely psychotic patients. Milestones based on such ratings should be defined, similar to the PANSS-based Remission criteria. FAST-O is such an instrument (11 items and a CGI rating).
Reliability, validity and factor structure were analyzed in four separate studies--most importantly in one study of 33 chronic forensic in-patients rated concurrently by three independent raters, and another study of 91 Psychiatric Intensive Care Units patients and 20 newly admitted forensic patients, rated twice, each time by two independent raters.
The factor structure was simple, two factors and an orphan item (Depression). Reliability was adequate on item (>0.75) as well as scale (>0.85) level. There was no bias related to the rater's professional background. The instrument was sensitive to change. Percentile-based algorithms allow characterization of patients and groups. Tentative treatment milestones are defined; a clinical state "half-way" between the acute state and remission.
FAST-O is a reliable, valid and easy to implement observation scale for patients with a psychotic illness, which can be used without bias by all staff.
International Journal of Psychiatry in Clinical Practice 09/2011; 15(3):180-95. · 0.43 Impact Factor
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ABSTRACT: 51 outpatients (aged 16–57 yrs) with a chronic psychotic illness (92% schizophrenia) were treated with the depot neuroleptic drugs perphenazine, flupenthixol, zuclopenthixol, or haloperidol decanoate. The depot doses were transformed into oral chlorpromazine (OC) equivalents to make comparisons possible. 29 Ss took antiparkinsonian drugs (APDs) also. Ss were assessed with the Comprehensive Psychopathological Rating Scale, the Clinical Global Impressions Scale, and the Abnormal Involuntary Movement Scale at study entry for clinical symptoms and side effects, and drug plasma levels were taken. Results suggest that choice of drug was not related to clinical symptoms. Although there were no differences in plasma level and OC equivalents, compared to other Ss, Ss taking APDs had more negative symptoms, more affective symptoms, and more positive symptoms, especially if they were taking perphenazine also. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Nordic Journal of Psychiatry 10/1994; · 0.98 Impact Factor
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Lakartidningen 106(26-27):1704-5.
