What Can We Learn About Psycho-social Functioning of Individuals Diagnosed with Schizophrenia From Standardized Patients?

Abstract

Treatment of patients with schizophrenia can be improved by precise administration of rating scales. The Positive and Negative Syndrome Scale (PANSS) is a commonly used tool to assess symptoms of schizophrenia. In order to develop a participatory learning program that aims to enhance raters training and increase inter-rater reliability we trained five actors to serve as standardized patients (SP). A training program for SPs was constructed using a narrative analysis scheme in the following manner: 1) Seven transcripts of SCI-PANSS interviews were analyzed and subdivided into thematic chapters including: symptom frequency, intensity, complexity, interference and impairment; 2) Script/story analysis of transcribed interviews were conducted where we identified scripted elements common among all seven interviews and storied elements that deviate from the script and have a function to individuate each of the interviews; 3) Linguistic markers (words, phrases, or discursive patterns indicative of symptoms and their severity) that are often seen as hallmarks of aetiology of schizophrenia were identified; 4) Symptoms were divided into two severity levels, moderate and severe, and three full SCI-PANSS interview scripts were built; 5) A workshop for five professional actors was conducted under the supervision of an expert PANSS interviewer. By studying the development of this program knowledge can be gained about a number of aspects related overall psycho-social functioning of individuals diagnosed with schizophrenia, such as the impact of semantic and discursive practices on interpersonal interactions and their further effect on the progress of the illness.