SCHIZOPRENIA
Brief Symptom Inventory (BSI),
a 53-item questionnaire to assess mood, anxiety, and psychotic symptoms in the last
seven days
Likert Scale from 0 to 4 (0 being not at all, 4 being extremely)
Measures 9 dimensions
● Somatization
● Obsession-Compulsion
● Interpersonal SensiƟvity
● Depression
● Anxiety
● Hostility
● Phobic Anxiety
● Paranoid Ideation
● Pyschotcism
Spielberger State Anxiety Questionnaire
● 20 items,
● Likert scale (1 to 4, 1: not at all, 4: very much so),
● statements such as “I feel calm”, “I feel tense”
Paranoia Scale (Fenigstein and Vanable, 1992),
● which measures ideas of persecution and reference.
● 20 items,
● self-report,
● 1 to 5 Likert scale,
● Scores range from 20-100,
● Higher scores indicate greater paranoid ideation.
VR Paranoia Scale
● o 15 items
● o Invented in this study
● o Self-report |
● o Likert Scale from 1 to 4 (1 being Disagree, 4 being totally Agree)
● “They were hostile towards me.”
● “They were watching me.”
● “They were looking at me critically.”
● “They were laughing at me.”
CPRS
● The CPRS is designed to evaluate the severity of psychiatric symptoms, observe
patient behavior, and assess changes in symptoms over time
● 65 items
● items covering symptoms commonly reported by patients with mental disorders
such as psychosis, mood disorders, anxiety disorders, and somatoform
disorders.
SANS
● Ratings are to be based on the last 30 days.
● 0-5 rating scale, plus unknown point
● “Decreased Spontaneous Movements”
● “Unchanging Facial Expression”
● rating scale that mental health professionals use to measure negative
symptoms in schizophrenia.
PANSS
● The scale is comprised of 30 items, divided into three subscales: positive
symptoms (7 items), negative symptoms (7 items), and general psychopathology
(16 items
● Each item is rated on a 7-point scale, where 1 represents absent and 7
represents extreme.
● The minimum possible score is 30 (all items scored 1) and the maximum
possible score is 210 (all items scored 7
● Positive Symptoms:
This subscale assesses symptoms like delusions, hallucinations, and conceptual
disorganization.
● Negative Symptoms:
This subscale assesses symptoms like blunted affect, emotional withdrawal, and
social withdrawal.
●
Pain
McGill Pain Questionnaire (MPQ)
● 20 questions that asses 4 different categories such as sensory, affective, etc.
● Affective (sickening, tiring), evaluative (annoying, intense), sensory (sharp,
flickering)
● Total 78 words, 0- no pain, 78- worst possible pain
● Asks what can reduce or increase pain ( eating, hot, cold, movement, etc)
● Measures the strength of pain; when it is worst, when it is best, and how it is now.
(Describe using adjectives such as horrible, excruciating, and distressing.
● Which word describes it at its worst? » mild, 1 » discomforting, 2 » distressing, 3
» horrible, 4 » excruciating, 5
● Weakness = closed questions, forced choice, lowers validity
● Weakness = No qualitative data gathered
● Strength = measures the detail of pain over time, gathers quantitative data (
statistical analysis can be done)
● Strength = easy and quick
● Holistic = covers almost all aspects, like sensory, affective, and evaluative
Visual Analogue Scale
● Designed to measure an attitude, feeling, or characteristic that cannot be
directly measured, like the subjective perception of pain along a
continuum of values
● 100 mm line that shows the extremities of what is being measured
(extreme pain to no pain)
● No pain (0-4mm), mild (5-44mm), moderate (45-74mm), severe
(75-100mm)
● Weakness = no qualitative data ( no in-depth insight), patients can't
explain the intensity of pain, so limited understanding
● Strength = quick and easy, practical in terms of allocating triads in case of
emergency, can measure changes over time, quantitative
UAB Scale
● A behavioral scale measures pain from a behaviorist perspective
● Observes symptoms like groans, rubbing the painful area, and facial grimaces
● Rated on a 3-point scale (0,0.5,1) (0- frequently, 1- none)
● Observed over a 3 week period
● non-verbal vocal complaints like groans moans gasps etc.
● Body language- rubbing affected area
● Mobility- like relaxing a limb
● Weakness = subjective, depends on the observer, the observer may miss details
or may not mark them accurately
● Some people do not express pain openly, so difficult to observe
● Does not correlate with the MPQ
●
Wong Baker Face Pain Rating Scale
● 6 faces, each with different facial expressions and ratings (0-10)
● ( no hurt, smiley face) ( hurts worse, crying face)
Colored Analogue Scale
● A colored line, usually 100 m long
● Colored green and red at opposite ends
● Green is no pain at all, whereas red is the worst pain
OCD
MOCI ocd measure
● 30 items
● true/false
● Measure 4 aspects: doubting, slowness, washing, checking
● “I do not take a long time to get ready in the morning” true/false
● “I avoid public transport due to fear of contamination.”
● Differentiates between people who have anxiety vs ppl who have obsessive
thinking.
● 18 and over is severe
Y-BCOS
● Semi-structured interview plus checklist
● Typically lasts 30 minutes
● How much of your time is occupied by obsessive thoughts? 0 (None) 1 (Less
than one hour a day) 2 (1–3 hours a day) 3 (3–8 hours a day) 4 (More than 8
hours a day)
● Severity of symptoms over the past week
● rated on 0-4 scale - Mild (8-15), moderate (16-23), severe (24- 31), extreme
(32-40) -
● 16 is the clinical range for OCD
● The checklist is also used to further assess symptoms
Measuring Non-Adherence
Subjective
● A frequently used questionnaire is the 10-item Medication Adherence Report
Scale (MARS), which has a forced-choice format asking for yes/no answers and
was originally designed to measure patients’ adherence to medication for
schizophrenia (Unni et al., 2019). Patients may also be given booklets to record
each time they take their medication.
● One weakness of using questionnaires is that the validity can be an issue if
patients give socially desirable answers. They may say that they have been
following their treatment when they have not, because they do not want their
doctor to know that they have not been taking their medication either at all or
regularly
● One strength of using questionnaires is that they are cheap and quick to
administer to a large number of patients; this will increase the ability to generalise
any results to the target population. You can also obtain quantitative data about
attitudes to adherence which can then be statistically analysed
Clinical interview
● A clinical interview is a dialogue between patient and clinician to help the
professional gain information which will help with diagnosis and treatment.
A clinical interview has a focused purpose, in this case to establish levels
of adherence. A clinical interview can be structured and unstructured
although the focus on these pages will be the semi-structured interview.
Semi-structured means that there will be some predetermined questions
which can be open or closed questions, but the focus will be on more
open-ended questions which will lead from the responses to the
predetermined questions. For example, if the patient then says they have
missed their medication three times, then more in-depth questioning about
their reasons for not taking it can be used. The focus for the clinical
interview should be solely on the patient. The Medical Adherence
Measure (MAM) was designed as a semi-structured clinical interview
designed to elicit detailed and accurate responses from patients about
whether they had adhered to their treatment and included questions about
diet, medication and clinic attendance.
● a weakness is that in comparison with questionnaires, which can be
administered online, it is a time-consuming and expensive method of
gathering data and researchers may have access to limited funding to
conduct their research, which might result in smaller sample sizes.
● A strength of the clinical interview is that it can provide detailed, rich
qualitative data about levels of adherence as well as reasons why they
may not be adhering; for example, in-depth questioning will provide
detailed data that can help improve patient adherence by providing
researchers with a greater understanding of patients worries and
concerns.
OBJECTIVE
1. Pill counting: calculate the number of doses that the patient should have
taken, then count the number of pills left in a bottle, and compare it with
the number of pills that should remain
● Patients may throw away pills so practitioners can't discover that they did
not adhere
Medication dispensers are portable devices that allow you to organise
medication by day and time. These devices provide reassurance to the patient by
dispensing the correct pills at a set day/time and can use visual or audio alarms
to alert the patient.
○ One disadvantage of medication dispensers is that they may not get
accurate results. Although the dispenser may record the medication being
removed, this does not mean that the person has taken the medication.
This means that this method lacks validity.
○ One advantage of this method is that it provides a reliable way to measure
adherence which is not affected by social desirability or errors of memory.
There is also an obvious advantage to the patient who is more likely to
stick to their treatment with reminders, meaning that they are less likely to
relapse and be admitted to hospital.
Biological tests :
Blood sampling ( drug levels in blood can be seen, glucose levels in blood, etc)
strength: reliable, accurate, quantitative, valid
Weakness: drug/ food interactions or individual metabolism of drugs can alter
results, it is invasive- maybe scared of needles. Can cause stress
Urine tests: check for glucose levels, drug levels in urine. Strength: reliable,
accurate, can be tested in labs, fairly cheap, chemical properties of urine do not
change rapidly, so it is stable. Weakness: uncomfortable, stressful, etc
