Greater initial severity on the 30-item Positive and Negative Syndrome Scale (PANSS-30) correlates positively with antipsychotic-placebo separation and trial dropout, but it is unknown whether these associations are present also on PANSS-derived subscales. We assessed the relationship between initial severity and antipsychotic-placebo separation as measured by PANSS-30 and four PANSS symptom subscales: the positive (PANSS-POS), negative (PANSS-NEG), general (PANSS-GEN) and 6-item (PANSS-6) subscales, using patient-level data from 18 placebo-controlled risperidone and paliperidone trials. Analysis of covariance in the intention-to-treat population (last-observation-carried-forward) was used to assess antipsychotic-placebo separation and trial dropout. Across 6685 participants (90% schizophrenia, 10% schizoaffective disorder), the initial severity-by-treatment interaction was statistically significant for PANSS-30 (beta: −0.155; p < 0.001) and all PANSS subscales (beta range: −0.097 to −0.135; p-value range: < 0.001 to 0.002). In all cases, antipsychotic-placebo differences increased with initial severity. Judging by the distribution of relative outcomes (percent remaining symptoms), the interaction was partly explained by an increased chance of responding, but also by larger numerical responses in those who did respond, as initial severity increased. Except for PANSS-NEG, high initial severity on all PANSS scales predicted increased trial dropout, although not statistically significantly so for PANSS-6. In summary, we thus replicate previous findings showing greater initial severity to predict larger antipsychotic-placebo separation and extend these results to four PANSS subscales. For PANSS-POS and PANSS-GEN, but not for PANSS-NEG and PANSS-6, we also replicate the association between initial severity and trial dropout. Patients with low initial negative symptom severity were identified as a group of particular interest for further study since their results diverged most from the average both with regard to antipsychotic-placebo separation (low separation measured by PANSS-NEG) and trial dropout (high level).

30 项阳性和阴性综合症量表 (PANSS-30) 的初始严重程度与抗精神病药-安慰剂分离和试验退出呈正相关，但尚不清楚这些关联是否也存在于 PANSS 衍生的分量表中。我们通过 PANSS-30 和四个 PANSS 症状分量表评估了初始严重程度与抗精神病药物-安慰剂分离之间的关系：阳性（PANSS-POS）、阴性（PANSS-NEG）、一般（PANSS-GEN）和 6 项（ PANSS-6) 分量表，使用来自 18 项安慰剂对照利培酮和帕潘立酮试验的患者水平数据。意向治疗人群（最后一次观察结转）的协方差分析用于评估抗精神病药-安慰剂分离和试验退出。在 6685 名参与者中（90% 精神分裂症，10% 分裂情感障碍），p  < 0.001) 和所有 PANSS 分量表（beta 范围：-0.097 至 -0.135；p-值范围：< 0.001 至 0.002)。在所有情况下，抗精神病药物与安慰剂的差异随着初始严重程度的增加而增加。从相对结果的分布（剩余症状的百分比）来看，相互作用的部分原因是响应机会增加，但随着初始严重程度的增加，响应者的数字响应也更大。除 PANSS-NEG 外，所有 PANSS 量表的初始严重程度较高都预示着试验退出率会增加，尽管 PANSS-6 在统计学上并不显着。总之，我们因此复制了先前的发现，显示初始严重程度更高，以预测更大的抗精神病药物-安慰剂分离，并将这些结果扩展到四个 PANSS 分量表。对于 PANSS-POS 和 PANSS-GEN，但对于 PANSS-NEG 和 PANSS-6，我们还复制了初始严重性和试验退出之间的关联。