Scales for the Assessment of Negative Symptoms (SANS)

The Scales for the Assessment of Negative Symptoms (SANS) is a 25-item assessment tool to measure negative symptoms in schizophrenia. The scale was developed in the early 1980s.
Description: The Scales for the Assessment of Negative Symptoms (SANS) is a 25-item assessment tool to measure negative symptoms in schizophrenia. The scale was developed in the early 1980s.
Disease States: Schizophrenia
Validated Uses: Screening, Treatment Monitoring & Evaluation, Symptom Severity
Administration Method: Clinician-report
Time to administer: 20 minutes
Commonly used in: Clinical Trials & Research, Clinical Practice
Detailed Description: The SANS is a scale that mental health professionals use to measure negative symptoms for patients with schizophrenia. The scale measures 25 items of negative symptoms across 5 categories: affective blunting, alogia, avolition-apathy, anhedonia-asociality, and inattention.1 Each item is rated on a scale from 0 (none) to 5 (severe) or unknown/cannot be assessed/not assessed.5 It is intended to cover the previous month.2 In psychopharmacological research, it can be used weekly to document treatment response.6 The clinician should also use other information sources in addition to the interview, including direct observation, family reports, and nursing reports.2
Scale Validity: The reliability and validity of the SANS have been assessed in multiple studies. Earlier studies found interrater reliability to be consistent.1
Alternative Versions: The SANS is complemented by the Scale for the Assessment of Positive Symptoms (SAPS), which is a similar tool that evaluates positive symptoms. Together, the scales are a comprehensive combination that can measure schizophrenia symptoms and assess changes over time.1
Cited Limitations: One criticism is that the duality of positive and negative scales is not diverse or complex enough for schizophrenia symptoms.1

Footnotes:

Supporting references are as follows:
Disease State: Schizophrenia1; Validated Uses: Research and clinician use1; Administration Method: Clinician or trained mental health professional1-6; Time to Administer: 20 minutes1,4; Commonly used in: Research4; Alternative Versions1; Cited Limitations1
 

This resource is intended for educational purposes only and is intended for US healthcare professionals. Healthcare professionals should use independent medical judgment. All decisions regarding patient care must be handled by a healthcare professional and be made based on the unique needs of each patient. 
 

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References:

  1. Kumari S, Malik M, Florival C, Manalai P, Sonje S. An assessment of five (PANSS, SAPS, SANS, NSA-16, CGI-SCH) commonly used symptoms rating scales in schizophrenia and comparison to newer scales (CAINS, BNSS). J Addict Res Ther. 2017;8(3):324. doi:10.4172/2155-6105.1000324 
  2. Andreasen NC. Negative symptoms in schizophrenia. Definition and reliability. Arch Gen Psychiatry. 1982;39(7):784-788. doi:10.1001/archpsyc.1982.04290070020005 
  3. Schoemaker J. An interview guide for the Scale for Assessment of Negative Symptoms (IG-SANS). Presented at: ISCTM 6th Annual Scientific Meeting; February 22–24, 2010; Washington, DC.  
  4. Marneros A, Andreasen NC, Tsuang MT. Negative Versus Positive Schizophrenia. Springer Berlin, Heidelberg; 1991:28-51. doi:10.1007/978-3-642-76841-5 
  5. Gejman PV. Scale for the Assessment of Negative Symptoms. Evanston Northwestern Healthcare. 1999;2:80-82. https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/GetPdf.cgi?id=phd000807.2 
  6. Andreasen NC. Scale for the Assessment of Positive Symptoms. University of Iowa; 1984:1-21.

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