Psychiatric University Hospital Zurich (KPPP), P.O. Box 1931, CH-8032 Zurich, Switzerland 27.12.
2011
Psychiatric University Hospital Zurich, Division of Clinical Psychiatry
SCALE FOR THE ASSESSMENT OF NEGATIVE SYMPTOMS
SANS
Nancy C. Andreasen
STUDY [____] 1-4
GROUP [__] 5-6
PATIENT [___] 7-9
RATING DAY [___] 10-12
CARD NUMBER [__] 13-14
Sex (1=male, 2=female) [_] 15
Birthday (dd.mm.yyyy) [__:__:____] 16-23
Date of hospitalization (dd.mm.yyyy) [__:__:____] 24-31
First diagnosis [___.__] 32-36
Second diagnosis [___.__] 37-41
Diagnostic system (1=ICD9, 2=ICD10, 3=DSM3-R, 4=DSM4) [_] 42
Age at onset [__] 43-44
Course (1=first manifestation, 2=intermittent, 3=progredient, 4=chronic) [_] 45
Duration of Current Episode Prior to Hospitalization (days) [___] 46-48
Medication Prior to Hospitalization (0=none, 1=antidepr., 2=neuroleptics, 3=other) [_] 49
Current Medication (cf. list of codes) [___] 50-52
Educational level (1=remedial, 2=junior high, 3=high, 4=college) [_] 53
DATE (dd.mm.yyyy) [__:__:____] 54-61
INTERVIEWER [___] 62-64
HOSPITAL [__] 65-66
PATIENT ID (the hospital’s internal PID) [____________] 67-78
2011
Psychiatric University Hospital Zurich (KPPP), P.O. Box 1931, CH-8032 Zurich, Switzerland 27.12.2011
0=None 1=Questionable 2=Mild 3=Moderate 4=Marked 5=Severe
1-12 dupl
0. CARD NUMBER [__] 13-14
1. AFFECTIVE FLATTENING OR BLUNTING
1 Unchanged Facial Expression [_] 15
The patient’s face appears wooden —changes less than expected as emotional
content of discourse changes.
2 Decreased Spontaneous Movements [_] 16
The patient shows few or no spontaneous movements, does not shift position,
move extremities, etc.
3 Paucity of Expressive Gestures [_] 17
The patient does not use hand gestures, body position, etc, as an aid in
expressing his ideas.
4 Poor Eye Contact [_] 18
The patient avoids eye contact or “stares through” interviewer even when
speaking.
5 Affective Nonresponsiveness [_] 19
The patient fails to laugh or smile when prompted.
6 Inappropriate Affect [_] 20
The patient’s affect is inappropriate or incongruous, not simply flat or blunted.
7 Lack of Vocal Inflections [_] 21
The patient fails to show normal vocal emphasis patterns, is often monotonic.
8 Global Rating of Affective Flattening [_] 22
This rating should focus on overall severity of symptoms, especially
unresponsiveness, eye contact, facial expression, and vocal inflections.
2. ALOGIA
9 Poverty of Speech [_] 23
The patient’s replies to questions are restricted in amount, tend to be brief,
concrete, unelaborated.
10 Poverty of Content of Speech [_] 24
The patient’s replies are adequate in amount but tend to be vague, overconcrete
or overgeneralized, and convey little in information.
11 Blocking [_] 25
The patient indicated, either spontaneously or with prompting, that his train of
thoughts was interrupted.
12 Increased Latency of Response [_] 26
The patient takes a long time to reply to questions; prompting indicates the
patient is aware of the question.
13 Global Rating of Alogia [_] 27
The core features of alogia are poverty of speech and poverty of content.
2
Psychiatric University Hospital Zurich (KPPP), P.O. Box 1931, CH-8032 Zurich, Switzerland 27.12.2011
0=None 1=Questionable 2=Mild 3=Moderate 4=Marked 5=Severe
3. AVOLITION – APATHY
14 Grooming and Hygiene [_] 28
The patient’s clothes may be sloppy or soiled, and he may have greasy hair,
body odor, etc.
15 Impersistence at Work or School [_] 29
The patient has difficulty seeking or maintaining employment, completing school
work, keeping house, etc. If an inpatient, cannot persist at ward activities, such as
OT, playing cards, etc.
16 Physical Anergia [_] 30
The patient tends to be physically inert. He may sit for hours and not initiate
spontaneous activity.
17 Global Rating of Avolition – Apathy [_] 31
Strong weight may be given to one or prominent symptoms if particularly striking.
4. ANHEDONIA – ASOCIALITY
18 Recreational Interests and Activities [_] 32
The patient may have few or no interests. Both the quality and the quantity of
interests should be taken into account.
19 Sexual Activity [_] 33
The patient may show decrease in sexual interest and activity, or enjoyment
when active.
20 Ability to Feel Intimacy and Closeness [_] 34
The patient may display an inability to form close or intimate relationships,
especially with opposite sex and family.
21 Relationships with Friends and Peers [_] 35
The patient may have few or no friends and may prefer to spend all his time
isolated.
22 Global Rating of Anhedonia – Asociality [_] 36
This rating should reflect overall severity, taking into account the patient’s
age, family status, etc.
5. ATTENTION
23 Social Inattentiveness [_] 37
The patient appears uninvolved or unengaged. He may seem “spacey”.
24 Inattentiveness During Mental Status Testing [_] 38
Test of “serial 7s” (at least five subtractions) and spelling “world” backwards.
Score 2 = 1 error, score 3 = 2 errors, score 4 = 3 errors.
25 Global Rating of Attention [_] 39
This rating should assess the patient’s overall concentration, clinically and on
tests.
