Perspectives on the Positive and Negative Syndrome Scale (PANSS): Use, misuse, drawbacks, and a new alternative for schizophrenia research

BACKGROUND: In 1987, Kay et al published the Positive and Negative Syndrome Scale (PANSS) and the PANSS manual to address the limitations of existing instruments for schizophrenia research. The PANSS has been one of the most widely used instruments in schizophrenia research until now. Because of recent advances in neuroscience research, it has become essential to reevaluate the performance of the PANSS since its development 3 decades ago. METHODS: A comprehensive literature review of the PANSS from 1987 to 2015 using a PubMed search was conducted. RESULTS: Five drawbacks to the PANSS have been cited in the literature. Although several authors have pointed out flaws of the PANSS, no revisions or modifications have been attempted to address them. In addition, some researchers do not use the PANSS as intended by the authors, and other researchers misuse it. CONCLUSIONS: The PANSS is a reliable and valid instrument that has served the scientific research community well for decades. New advances in experimental psychopathology and personalized psychiatry and the new National Institute of Mental Health paradigm of Research Domain Criteria necessitate a new instrument compatible with advances in clinical neuroscience research.