Negative symptoms represent an unmet need of treatment in schizophrenia. Although a consensus exists on negative symptom construct, and second generation assessment instruments reflecting the consensus are available, studies still rely upon old assessment instruments, that do not reflect recent conceptualizations and might limit progress in the search for effective treatments. This is often the case in the European context, where one of the challenges encountered in designing large studies is the availability of validated instruments in the many languages of the continent. To address this challenge and promote sound research on negative symptoms in Europe, the ECNP Schizophrenia Network coordinated a large multicenter, multinational validation study of the Brief Negative Symptom Scale (BNSS). Clinically-stable subjects with schizophrenia (SCZ, N = 249) were recruited from 10 European Countries. Apart from BNSS, subjects were administered the Positive and Negative Syndrome Scale (PANSS) and standardized instruments for depression, extrapyramidal symptoms and psychosocial functioning. Results showed an excellent internal consistency, convergent and discriminant validity of BNSS and replicated a 5 factor-model. A larger number of subjects with predominant negative symptoms, i.e. the target population for clinical trials, was identified by using the BNSS compared to the PANSS. Regression analysis showed that BNSS-avolition, a key negative symptom poorly assessed by PANSS, explained 23.9% of psychosocial functioning, while no combination of the PANSS core negative symptoms showed the same impact on functioning. The study demonstrated that BNSS has substantial advantages with respect to PANSS for the identification of the avolition domain and subjects with predominant negative symptoms.

6th Psychiatric Department Otto Wagner Spital Vienna Austria

Adult Psychiatry Division Department of Psychiatry University of Geneva Hospitals Geneva Switzerland

Center for Neuropsychiatric Schizophrenia Research Mental Health Center Glostrup Glostrup Denmark; Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark

Department of Adult Psychiatry Poznan University of Medical Sciences Poznan Poland

Department of Psychiatry and Psychotherapy Medical University of Vienna Vienna Austria

Department of Psychiatry and Psychotherapy Psychiatric Hospital University of Zurich Zurich Switzerland

Department of Psychiatry and Psychotherapy Semmelweis University Budapest Hungary

Department of Psychiatry Psychotherapy and Psychosomatics Division of Psychiatry 1 Medical University Innsbruck Innsbruck Austria

Department of Psychiatry University of Campania Luigi Vanvitelli Largo Madonna delle Grazie 80138 Naples Italy

Department of Socio clinical and Biological Research of Psychotic spectrum disorders Moscow Research Institute of Psychiatry Moscow Russia

Istanbul Faculty of Medicine Psychotic Disorders Research Program Istanbul University Istanbul Turkey

NORMENT Centre Institute of Clinical Psychiatry University of Oslo and Oslo University Hospital Oslo Norway

Psychiatric Department Charles University Medical School and Faculty Hospital Hradec Králové Hradec Králové Czechia

Psychiatric Research Unit Psychiatry Region Zealand Hillerød Denmark

Service de Psychiatrie CHU de Caen Caen France; UFR de Médecine UNICAEN Normandie Université Caen France; ISTS UNICAEN Normandie Université Caen France

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European Validation of the Self-Evaluation of Negative Symptoms (SNS): A Large Multinational and Multicenter Study