The Positive and Negative Syndrome Scale—Spanish Adaptation

KAY, STANLEY R.; FISZBEIN, ABRAHAM; VITAL-HERNE, MARC; FUENTES, LUIS SILVA

doi:10.1097/00005053-199008000-00007

Cited by 122Schizophrenia research and treatmentPsychometric Methodologies and TestingMental Health and Psychiatry

The Positive and Negative Syndrome Scale—Spanish Adaptation

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KAY, STANLEY R., FISZBEIN, ABRAHAM, VITAL-HERNE, MARC, FUENTES, LUIS SILVA·1990·The Journal of Nervous and Mental Disease

DOI 10.1097/00005053-199008000-00007

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Abstract

The Positive and Negative Syndrome Scale (PANSS) consists of a formalized clinical interview and 30 operationally defined items for psychopathology assessment. We report here on the psychometric equivalence of a Spanish language adaptation (PANSS-S), de-veloped to facilitate minority group, multinational, and cross-cultural studies on schizophrenia. Two bilingual psychiatrists simultaneously rated 57 psychiatric inpatients using the PANSS (N = 20), PANSS-S (N = 20), or both methods (N = 17). The PANSS-S demonstrated sound interrater reliabilities (r = .93 for positive and .74 for negative syndrome, p < .001), which were similar to those from the current PANSS assessment and original standardization studies. In support of criterion-related validity, the means and variance of the two instruments were comparable, and significant cross-correlations were obtained for the principal scales (r = .92 for positive and .83 for negative syndrome, p < .0001), component symptoms, and five additional psychopathology clusters. The results suggest that the PANSS-S has psychometric properties resembling those of the PANSS and may be used interchangeably in a Spanish-speaking population. —J Nerv Ment Dis 178:510-517, 1990

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The Spanish version of the PANSS subscales are strongly associated with the original version (r = 0.92 for PANSS-P and r = 0.83 for PANSS-N), with item correlations ranging from r = 0.64 to r = 0.97 and high inter-rater reliability (r = 0.81).
“Subscales of Spanish version are strongly associated with the original version (r = 0.92 for PANSS-P and r = 0.83 for PANSS-N), with item correlations ranging from r = 0.64 to r = 0.97 and high inter-rater reliability (r = 0.81) [39].”
From Mindfulness-based social cognition training (SocialMIND) versus psychoeducational multicomponent intervention for people with a first episode of psychosis: A study protocol for a randomised controlled trial (2019) · cites this paper as [39]

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Sánchez‐Gistau, V., García-Manzanares, N., Cabezas, Á., Solé, M., Algora, M., & Vilella, E. (2020) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2020.05.010 · Cited by 15 · see citing works
Autobiographical memory in schizophrenia: The role of metacognition
Mediavilla, R., López-Arroyo, M., Gómez-Arnau, J., Wiesepape, C. N., Lysaker, P. H., & Lahera, G. (2021) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2021.152254 · Cited by 13 · see citing works
“Positive and Negative Syndrome Scale (PANSS) [43], Spanish version [44].”
Background
Cariprazine as a maintenance treatment in dual schizophrenia: a 6-month observational study in patients with schizophrenia and cannabis use disorder
Szerman, N., Vega, P., Roncero, C., Peris, L., Grau‐López, L., & Basurte-Villamor, I. (2024) · International Clinical Psychopharmacology · doi:10.1097/yic.0000000000000568 · Cited by 12 · see citing works
“Cariprazine was effective in addressing overall symptoms of schizophrenia as measured by the PANSS and the CGI-SCH.”
Influential
Estimation of Correlation Dimension to Evaluate Cognitive Performance in Schizophrenic Patients Using a New Computer Technique
Hornero, R., Alonso, A., Bulnes, N. J., et al. (1999) · Nonlinear Dynamics Psychology and Life Sciences · doi:10.1023/a:1022419023008 · Cited by 11 · see citing works
Delusional beliefs in adolescents with anorexia nervosa, obsessive-compulsive disorder, or first-episode psychosis: A comparative study
Camprodon‐Boadas, P., de la Serna, E., Plana, M. T., Flamarique, I., Lázaro, L., Borràs, R., Baeza, I., Tasa-Vinyals, E., Sugranyes, G., Ortiz, A. E., et al. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115490 · Cited by 11 · see citing works
Progressive loss of cortical gray matter in first episode psychosis patients with auditory hallucinations
García‐Martí, G., Escartí, M. J., Nácher, J., Pérez-Rando, M., Mané, A., Usall, J., Berrocoso, E., Pomarol‐Clotet, E., López-Ilundain, J. M., Cuesta, M. J., et al. (2023) · Schizophrenia Research · doi:10.1016/j.schres.2023.11.011 · Cited by 10 · see citing works
Possible influence of CREB1, CREBBP and CREM variants on diagnosis and treatment outcome in patients with schizophrenia
Crisafulli, C., Chiesa, A., Han, C., Lee, S.-J., Shim, D. S., Balzarro, B., Andrisano, C., Sidoti, A., Patkar, A. A., Pae, C., et al. (2011) · Neuroscience Letters · doi:10.1016/j.neulet.2011.12.013 · Cited by 10 · see citing works
The effect of language on functional capacity assessment in middle-aged and older US Latinos with schizophrenia
Bengoetxea, E., Burton, C. Z., Mausbach, B. T., Patterson, T. L., & Twamley, E. W. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2014.04.011 · Cited by 9 · see citing works
“Psychiatric symptom severity was measured with the Positive and Negative Syndrome Scale (PANSS) (Kay et al., 1987; Kay et al., 1990) and the Hamilton Rating Scale for Depression (Hamilton, 1960; Ramos-Brieva and Cordero-Villafafila, 1988).”
Method
Actitud respecto a la medicación antipsicótica como factor predictivo de la suspensión del tratamiento antipsicótico en el período inicial de la psicosis de inicio temprano
Fraguas, D., Llorente, C., Rapado‐Castro, M., Parellada, M., Moreno, D. M., Ruíz-Sancho, A., Medina, Ó., Alvarez‐Segura, M., de Castro, M. J., & Arango, C. (2008) · Revista de Psiquiatría y Salud Mental · doi:10.1016/s1888-9891(08)72511-4 · Cited by 10 · see citing works
Validation of a specific measure to assess health-related quality of life in patients with schizophrenia and bipolar disorder: the 'Tolerability and quality of life' (TOOL) questionnaire
Montejo, A. L., Correas-Lauffer, J., Cuervo, J., Rebollo, P., Cordero, L., Díez, T., & Mauriño, J. (2011) · Annals of General Psychiatry · doi:10.1186/1744-859x-10-6 · Cited by 9 · see citing works
“Investigators completed the following scales: Positive and Negative Syndrome Scale (PANSS) [19] (only to patients with schizophrenia), Young Mania Rating Scale (YMRS) [20] (only to patients with bipolar disorder), Montgomery-Asberg Depression Scale (MADRS) [21], Clinical Global Impression - Severity scale (CGI-S) [22]…”
Method
Mindfulness on Daily Life Coping in People Experiencing Psychosis: A Randomized Controlled Trial
López-Navarro, E., & Al‐Halabí, S. (2022) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2022.100298 · Cited by 8 · see citing works
Attitude Toward Antipsychotic Medication as a Predictor of Antipsychotic Treatment Discontinuation in First-Episode Early-Onset Psychosis
Fraguas, D., Llorente, C., Rapado‐Castro, M., Parellada, M., Moreno, D. M., Ruíz-Sancho, A., Medina, Ó., Alvarez‐Segura, M., de Castro, M. J., & Arango, C. (2008) · Revista de Psiquiatría y Salud Mental (English Edition) · doi:10.1016/s2173-5050(08)70054-2 · Cited by 8 · see citing works
Mindfulness-Based Social Cognition Training (SocialMind) for People With Psychosis: A Feasibility Trial
Mediavilla, R., Muñoz-Sanjosé, A., Rodríguez-Vega, B., Bayon, C., Lahera, G., Palao, Á., & Bravo-Ortiz, M. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00299 · Cited by 8 · see citing works
Free Thyroxine Concentrations Moderate the Response to a Cognitive Remediation Therapy in People With Early Psychosis: A Pilot Randomized Clinical Trial
Estrada, F., Crosas, J. M., Ahuir, M., Pérez-Muñoz, S., Zabala, W., Aguayo, R., Barbero, J. D., Montalvo, I., Tost, M., Llauradó, L., et al. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00636 · Cited by 7 · see citing works
“PANSS was used to assess the severity of psychotic symptoms (42).”
Method
Cognitive biases in first-episode psychosis with and without attention-deficit/hyperactivity disorder
Sánchez‐Gistau, V., Cabezas, Á., Manzanares, N., Solé, M., Corral, L., Vilella, E., & Gutiérrez‐Zotes, A. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1127535 · Cited by 6 · see citing works
Integration of Pharmacological and Psychosocial Treatment for Schizophrenia in Mexico: The Case of a Developing Country Proposal
Valencia, M., Diaz, A., & Juárez, F. (2012) · InTech eBooks · doi:10.5772/34618 · Cited by 6 · see citing works
“The Positive and Negative Syndrome Scale [PANSS], Spanish adaptation, (Kay et al., 1990), and the Global Assessment of Functioning Scale [GAF] (APA, 1995), were used to assess psychopathology and psychosocial functioning.”
Method
Perceptual/attentional anomalies in schizophrenia: A family study
Reyes, M. M., Quiñones, R. M., de Villalvilla, T. D., & Sosa, M. V. (2010) · Psychiatry Research · doi:10.1016/j.psychres.2009.03.033 · Cited by 6 · see citing works
The Affective and Emotional Composite Temperament Scale (AFECTS): Psychometric properties of the Spanish version in a community sample from Mexico City and comparison between remitted psychiatric patients
Romo-Nava, F., Fresán, A., Barragán, V., et al. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.09.053 · Cited by 6 · see citing works
Mindfulness-based social cognition training (SocialMIND) versus psychoeducational multicomponent intervention for people with a first episode of psychosis: A study protocol for a randomised controlled trial
Mediavilla, R., Muñoz-Sanjose, A., Rodriguez-Vega, B., Bayon, C., Palao, A., Lahera, G., Sanchez-Castro, P., Roman, E., Cebolla, S., de Diego, A., et al. (2019) · BMC Psychiatry · doi:10.1186/s12888-019-2206-4 · Cited by 5 · see citing works
Relación entre el maltrato infantil y la adaptación social en una muestra de jóvenes atendidos en un servicio de intervención precoz en psicosis
Ortega, L., Montalvo, I., Solé, M., Creus, M., Cabezas, Á., Gutiérrez‐Zotes, A., Sánchez‐Gistau, V., Vilella, E., & Labad, J. (2020) · Revista de Psiquiatría y Salud Mental · doi:10.1016/j.rpsm.2020.05.001 · Cited by 5 · see citing works
Detection, Assessment, and Management of Schizophrenia in an Andean Population of South America: Parkinsonism Testing and Transcranial Ultrasound as Preventive Tools
Balda, M. A., Calvó, M., Padilla, E., et al. (2015) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20150018 · Cited by 4 · see citing works
“Clinical assessments used to measure psychopathology were the PANSS for schizophrenia (40) and the CGI severity scale (41).”
Method
Diferencias en la presentación clínica de primeros episodios psicóticos entre población de origen marroquí y población autóctona
Arranz, S., Camacho, J., Andrés, C., Niubó, I., & Sánchez‐Gistau, V. (2019) · Revista de Psiquiatría y Salud Mental · doi:10.1016/j.rpsm.2019.03.004 · Cited by 4 · see citing works
Relationship between childhood trauma and social adaptation in a sample of young people attending an early intervention service for psychosis
Ortega, L., Montalvo, I., Solé, M., Creus, M., Cabezas, Á., Gutiérrez‐Zotes, A., Sánchez‐Gistau, V., Vilella, E., & Labad, J. (2020) · Revista de Psiquiatría y Salud Mental (English Edition) · doi:10.1016/j.rpsmen.2020.08.002 · Cited by 4 · see citing works
Disrupted serial dependence suggests deficits in synaptic potentiation in anti-NMDAR encephalitis and schizophreniaPreprint
Stein, H., Barbosa, J., Rosa-Justícia, M., Prades, L., Morató, A., Galan, A., Ariño, H., Martínez‐Hernández, E., Castro‐Fornieles, J., Dalmau, J. O., et al. (2019) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/830471 · Cited by 4 · see citing works
Longitudinal changes in striatocortical connectivity in first-episode psychosis associated with the emergence of treatment resistance
Tepper, Á., Núñez, J. V., Dellarossa, C. D., Ramírez-Mahaluf, J. P., Aguirre, J. M., Barbagelata, D., Aceituno, D., Undurraga, J. P., Nachar, R., Mena, C., et al. (2025) · Schizophrenia · doi:10.1038/s41537-025-00653-7 · Cited by 3 · see citing works
Awareness of illness and suicidal behavior in delusional disorder patients
Molina-Andreu, O., González-Rodríguez, A., Pons, A., Penadés, R., Catalán, R., & Bernardo, M. (2014) · Archives of Clinical Psychiatry (São Paulo) · doi:10.1590/0101-60830000000034 · Cited by 4 · see citing works
Comparison of three different exercise training modalities (aerobic, strength and mixed) in patients with schizophrenia: study protocol for a multicentre randomised wait-list controlled trial
Garcés, L. G., Cano, S. L., Meliá, Y. C., Sánchez‐López, M. I., Marqués-Azcona, D., Lisón, J. F., & Peyró-Gregori, L. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-046216 · Cited by 3 · see citing works
Sex differences in changes in prolactin levels and sexual function after switching from risperidone to paliperidone palmitate in schizophrenia
Tost, M., Barbero, J. D., Montalvo, I., González-Rodríguez, A., Aguayo, R., Pedrero, A. Á., Gabernet, R., Izquierdo, E., Merodio, I., Acebillo, S., et al. (2024) · The European Journal of Psychiatry · doi:10.1016/j.ejpsy.2024.100259 · Cited by 2 · see citing works
Neural signatures of reduced serial dependence in anti-NMDAR encephalitis and schizophreniaPreprint
Stein, H., Barbosa, J., Lozano‐Soldevilla, D., Rosa-Justícia, M., Morató, A., Galan-Gadea, A., Prades, L., Muñoz-Lopetegui, A., Ariño, H., Martínez‐Hernández, E., et al. (2024) · doi:10.31234/osf.io/kz73s · Cited by 1 · see citing works
Predictors of hospital admission during home follow-up with a crisis resolution and home treatment team on 1045 patients with schizophrenia
Córcoles, D., Talisa, R., Malagón, A., et al. (2025) · International Journal of Mental Health · doi:10.1080/00207411.2025.2499221 · Cited by 1 · see citing works
“To assess schizophrenia severity, we used the Positive and Negative Syndrome Scale (PANSS) (Kay et al., 1990).”
Comparison between a morocco and a native-born population, in a sample of first episode psychosis
Arranz, S., Camacho, J., Andrés, C., Niubó, I., & Sánchez‐Gistau, V. (2020) · Revista de Psiquiatría y Salud Mental (English Edition) · doi:10.1016/j.rpsmen.2020.07.002 · Cited by 1 · see citing works
Recent Advances in the Understanding of Negative Symptoms in Schizophrenia
Littrell, S. H., & Littrell, K. H. (1997) · Journal of the American Psychiatric Nurses Association · doi:10.1177/107839039700300405 · Cited by 1 · see citing works
Assessing Psychosis in Hispanics
Cárdenas, V., Helu, P., Tiznado, D., et al. (2012) · Springer eBooks · doi:10.1007/978-1-4614-4412-1_17
Comparison of Correlations between Symptom Dimensions and Subjective Quality Of Life in Mexican Outpatients with Psychosis
Gómez-de-Regil, L., Rubio-Zapata, H., & Castillo, D. F. E. (2018) · Neuropsychiatry · doi:10.4172/neuropsychiatry.1000367
Clinical and Functional Outcomes in Day Hospitals in Times of COVID-19
Estrada-Zambrano, N., Martinez-Ferreira, C., & Figueroa, J. C. R. (2022) · Revista Colombiana de Psiquiatría · doi:10.1016/j.rcp.2022.12.001
“Suicidal risk was assessed with the clinician-rated Suicidal Scale of the Mini International Neuropsychiatric Interview (MINI).22,23 The psychopathological assessment included a diagnostic interview, the clinician-rated Global Assessment Scale (GAS),24 and clinical scales according to diagnosis such as the self-admini…”
Influential
Consent for Research Involving Spanish- and English-Speaking Latinx Adults With Schizophrenia
Barrio, C., Fuentes, D., Tibiriçá, L., Hernández, M., Helu-Brown, P., Golshan, S., & Palmer, B. W. (2023) · Schizophrenia Bulletin · doi:10.1093/schbul/sbad159
Acculturation and clinical symptoms of schizophrenia among Latine adults in the United States
Tibiriçá, L., Kohn, J. N., Patapoff, M. A., Williams, A. P., Palmer, B. W., & Barrio, C. (2024) · Schizophrenia Research · doi:10.1016/j.schres.2024.02.021
Clinical and Functional Outcomes in Day Hospitals in Times of COVID-19
Estrada-Zambrano, N., Martinez-Ferreira, C., & Figueroa, J. C. R. (2025) · Revista Colombiana de Psiquiatría (English ed ) · doi:10.1016/j.rcpeng.2022.12.001
Differential effect of cannabis use and antipsychotic medication on extracellular free-water in the brain of individuals with early psychosis and controls
Martínez-Sadurní, L., Barrera-Conde, M., Robledo, P., Veza-Estévez, E., García-Quintana, J., Mané, A., Toll, A., Trabsa, A., Lesh, T. A., Carter, C. S., et al. (2025) · Molecular Psychiatry · doi:10.1038/s41380-025-03287-4
“…using the MINI interview, BMI was measured and registered, psychotic symptoms were assessed using the Positive and Negative Syndrome Scale [54], negative symptoms were measured using the BNSS [55, 56], general functioning was evaluated using the DAS-WHO [57], and a history of…”
Integrated clinical and postmortem profiling in schizophrenia reveals a cognitive subtype linked to cerebrovascular disease
Futhey, N. C., Vila‐Rodriguez, F., Stochmanski, S. J., Gregory, E., Honer, W. G., Arranz, B., Ramos, B., Escanilla, A., Vera-Montecinos, A., Cembrowski, M. S., et al. (2026) · Translational Psychiatry · doi:10.1038/s41398-026-03984-w
“…Impressions), functioning (Global Assessment of Functioning), and a comprehensive neuropsychological testing battery validated for use in Spanish [54 – 57]: Frontal Assessment Battery (FAB), Memory Impairment Screen (MIS), F-A-S test, Consortium to Establish a Registry for Alzheimer ’ s Disease…”
Perinatal stress as a moderator of the effects of hormonal dysregulation on cognition and symptoms in early psychosis
Gago, E., Montalvo, I., Cabezas, Á., Ortega, L., Solé, M., Martorell, L., Vilella, E., García‐Rizo, C., & Labad, J. (2026) · Schizophrenia Research · doi:10.1016/j.schres.2026.04.001
Endocannabinoid plasma concentrations and their relationship with clinical outcome and cannabis use in antipsychotic-naïve first episode psychosis
Martínez-Sadurní, L., Toll, A., Olivares-Berjaga, D., Rodríguez, N., Martínez-Pinteño, A., Haro, J. M., Trabsa, A., Bergé, D., Pérez, V., & Mané, A. (2026) · Psychiatry Research · doi:10.1016/j.psychres.2026.117479

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A new five factor model of schizophrenia
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Schizophrenia patients with a metabolically abnormal obese phenotype have milder negative symptomsPreprint
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Sex differences in prepsychotic "prodromal" symptomatology and its association with Positive and Negative Syndrome Scale active phase psychopathology in male and female patients.
Moukas, G., Gourzis, P., Beratis, I., & Beratis, S. (2010) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2009.11.003 · Cited by 12 · see citing works

Authors: KAY, S. R., FISZBEIN, A., VITAL-HERNE, M., & FUENTES, L. S.
Affiliations: Albert Einstein College of Medicine (US)
Harlem Hospital Center (US)
Universidad de La Frontera (CL)
Venue: The Journal of Nervous and Mental Disease
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1990-08
Volume: 178
Issue: 8
Pages: 510-517
ISSN: 0022-3018 (ISSN-L)
DOI: 10.1097/00005053-199008000-00007
OpenAlex: W2028150712
Cited by: 122
References: 0
Citations by year: 2026: 4 · 2025: 5 · 2024: 4 · 2023: 5 · 2022: 3 · 2021: 2 · 2020: 10 · 2019: 6 · 2018: 4 · 2017: 2 · 2016: 3 · 2015: 12 · 2014: 8 · 2013: 3 · 2012: 4
FWCI: 0.38
Type: journal article
Language: en
Open access: green
repositorio.ufro.cl
Licence: cc-by-nc-nd
Locations: The Journal of Nervous and Mental Disease (publishedVersion)
PubMed (publishedVersion)
Omeka S (Universidad de La Frontera) (submittedVersion, cc-by-nc-nd)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Keywords: PANSS, Spanish adaptation, schizophrenia, psychopathology assessment, inter-rater reliability, criterion validity, cross-cultural adaptation, psychiatric inpatients
MeSH terms: Adult, Animals, Cross-Cultural Comparison, Diagnosis, Differential, Female, Hospitalization, Humans, Language, Male, Minority Groups, Psychiatric Status Rating Scales, Psychometrics, Schizophrenia, Schizophrenic Psychology, Spain

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The Positive and Negative Syndrome Scale—Spanish Adaptation

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