Scale for the Assessment of Negative Symptoms (SANS) of Andreasen for Patients with Schizophrenia

 

Features of negative schizophrenia:

(1) flattened affect (blunting)

(2) alogia (marked poverty of speech, poverty of speech content)

(3) avolition-apathy (anergia, imperistence at work or school)

(4) anhedonia-asociality (inability to experience pleasure or to feel intimacy; few social contacts)

(5) attentional impairment

 

NOTE: Each subgroup contains evaluation of subjective and global ratings for the group.

 

Symptoms associated with flattened affect (9):

(1) unchanging facial expression

(2) decreased spontaneous movement

(3) paucity of expressive gestures

(4) poor eye contact

(5) affective nonresponsivity

(6) inappropriate affect

(7) lack of vocal inflections

(8) subjective rating of affecting flattening

(9) global rating of affective flattening

 

Symptoms associated with alogia (6):

(1) poverty of speech

(2) poverty of speech content

(3) blocking

(4) increased latency of responses

(5) subjective rating of alogia

(6) global rating of alogia

 

Symptoms associated with avolition-apathy (5):

(1) grooming and hygiene

(2) impersistence at work or school

(3) physical anergia

(4) subjective complaints of avolition-apathy

(5) global rating of avolition-apathy

 

Symptoms associated with anhedonia-asociality (6):

(1) recreational interests and activities

(2) sexual interests and activity

(3) ability to feel intimacy and closeness

(4) relationships with friends and peers

(5) subjective awareness of anhedonia-asociality

(6) global rating of anhedonia-asociality

 

Symptoms associated with attentional impairment (4) :

(1) work inattentiveness

(2) inattentiveness during mental status testing

(3) subjective complaints of inattentiveness

(4) global rating of inattentiveness

 

Each symptoms is graded on a 6-point Likert scale.

Symptom	Points
none	0
questionable	1
mild	2
moderate	3
marked	4
severe	5

 

subscore =

= SUM(points for each symptom group)

 

total (composite) score =

= SUM(points for all 30 symptoms)

 

global rating score =

= SUM(points for the 5 global ratings)

 

Interpretation:

• minimum total score: 0

• maximum total score: 150

• maximum subscore for flattened affect: 45

• maximum subscore for alogia: 30

• maximum subscore for avolition-apathy: 25

• maximum subscore for anhedonia-asociality: 30

• maximal subscore for attentional impairment: 20

• maximum global rating subscore: 25

• The higher the scores, the more greater the degree in the deficit.

 

Performance:

• The interrater reliability is excellent.

• There is good internal consistency.

• The conceptual organization is cohesive.