Scale for Assessing Positive Symptoms, SAPS Test - the question form

0 – None

1 – Questionable pathology (the presence of hallucinations is doubtful)

2 – Mild – occasionally hears noises or single words

3 – Moderate – voices are clearly present, but no more than once a week

4 – Marked – voices are clearly present and occur frequently

5 – Severe – voices occur daily

0 – Absent

1 – Questionable pathology

2 – Mild – commentary occurred once or twice

3 – Moderate – commentary voices occur at least once a week

4 – Marked – frequent occurrence of commentary voices

5 – Severe – daily voices with a commentary content

0 – none

1 – questionable pathology

2 – mild – occurred once or twice

3 – moderate – voices conversing with one another occur at least once a week

4 – marked – frequent occurrence of voices conversing with one another

5 – severe – daily voices conversing with one another

0 – Absent

1 – Questionable

2 – Mild – the phenomenon has occurred at least once

3 – Moderate – the phenomenon occurs at least once a week

4 – Marked – frequent somatic or tactile hallucinations

5 – Severe – daily somatic or tactile hallucinations

0 – absent

1 – questionable pathology

2 – mild – olfactory hallucinations have occurred at least once

3 – moderate – olfactory hallucinations occur at least once a week

4 – marked – frequent olfactory hallucinations

5 – severe – daily olfactory hallucinations

0 – absent

1 – questionable pathology

2 – mild – the phenomenon occurs at least once

3 – moderate – visual hallucinations occur at least once a week

4 – marked – frequent visual hallucinations

5 – severe – daily visual hallucinations

0 – None

1 – Questionable pathology – the presence of hallucinations is doubtful

2 – Mild – hallucinations are definitely present, but occur very rarely and are sometimes doubted by the patient

3 – Moderate – fairly distinct hallucinations occur periodically and are a source of embarrassment for the patient

4 – Marked – frequent and vivid hallucinations, often determining the patient’s life and behavior

5 – Severe – hallucinations daily, often bizarre or fantastic, very vivid, and completely determine the patient’s behavior

0 – Absent.

1 – Questionable pathology.

2 – Mild – delusional ideas are rudimentary, unstable, and may take various forms; the patient may express doubts about their existence.

3 – Moderate – clear, well-formed delusional ideas accompanied by firm conviction.

4 – Marked – prominent persecutory delusions accompanied by firm conviction and prompting protective actions.

5 – Severe – extensive, systematized persecutory delusions that determine the patient’s behavior most of the time; some aspects of the delusions or delusional behavior may be absurd or bizarre.

0 – Absent

1 – Questionable pathology

2 – Mild – delusional conviction is limited; jealous ideas are fragmentary, unstable, and may take various forms; the patient may express doubts about their existence

3 – Moderate – clear and well-formed jealous delusions, accompanied by firm conviction

4 – Marked jealous delusions, accompanied by firm conviction and prompting corresponding actions

5 – Severe – extensive and systematized jealous delusions that determine the patient’s behavior most of the time; some aspects of the delusions or delusional behavior may be absurd or bizarre

0 – Absent

1 – Questionable pathology

2 – Mild – Delusional ideas are rudimentary, unstable, and may take various forms; the patient may express doubts about their existence

3 – Moderate – Clear and well-developed delusional ideas accompanied by firm conviction

4 – Marked – Prominent delusions of guilt or sin accompanied by firm conviction and prompting corresponding actions

5 – Severe – Extensive and systematized delusions of guilt or sin that determine the patient’s behavior most of the time; some aspects of the delusions or delusional behavior may be absurd or bizarre

0 – Absent

1 – Questionable pathology

2 – Mild – delusions of grandeur are rudimentary, unstable, and may take various forms; the patient may express doubt about them

3 – Moderate – clear and well-developed delusions, with firm conviction

4 – Marked delusions of grandeur, with firm conviction and leading the patient to act accordingly

5 – Severe – elaborate and systematized delusions of grandeur that determine the patient’s behavior most of the time; some aspects of the delusions or delusional behavior may be bizarre or odd

0 – Absent

1 – Questionable pathology

2 – Mild: delusional ideas are rudimentary, unstable, and may take various forms; the patient may express doubts about their existence

3 – Moderate: clear, well-developed delusional ideas with firm conviction

4 – Marked: prominent religious delusional ideas with firm conviction, leading the patient to act accordingly

5 – Severe: extensive, systematized religious delusional ideas that determine the patient’s behavior most of the time; some aspects of the delusion or delusional behavior may be absurd or bizarre

0 – Absent.

1 – Questionable pathology.

2 – Mild – delusional ideas are rudimentary, unstable, and may take various forms; the patient may express doubt about their existence.

3 – Moderate – clear and well-substantiated delusional ideas accompanied by firm conviction.

4 – Marked – pronounced hypochondriacal delusional ideas accompanied by firm conviction and prompting corresponding actions.

5 – Severe – extensive, systematized hypochondriacal delusional ideas that determine the patient’s behavior most of the time; some aspects of the delusion or delusional behavior may be absurd or bizarre.

0 – absent

1 – questionable pathology

2 – mild – ideas of reference are slight but definite

3 – moderate – pronounced delusions of reference

4 – marked delusions of reference, occurring at least once per week

5 – severe – frequent delusions of reference

0 – Absent

1 – Questionable pathology

2 – Mild – the patient feels that their actions are controlled from time to time, but doubts this

3 – Moderate – clear, repeatedly occurring experiences of being influenced by outside forces

4 – Marked – frequent ideas of being controlled that are reflected in the patient’s behavior

5 – Severe – prominent and frequent delusional ideas of being controlled that fully dominate the patient’s personality and influence behavior

0 – Absent

1 – Questionable pathology

2 – Mild – the patient feels that their thoughts have been known (read), but has doubts that this is possible

3 – Moderate – clear experiences of mind reading, recurring several times

4 – Marked and frequent experiences of mind reading, sometimes affecting the patient’s behavior

5 – Severe – marked and frequent experiences of thought openness or mind reading, fully preoccupying the patient and regularly influencing their behavior

0 – Absent

1 – Questionable pathology

2 – Mild – delusional ideas are fragmentary, unstable, and may take various forms; the patient may express doubt that they are true

3 – Moderate – definite, recurrent experiences of thought broadcasting

4 – Marked and frequent experiences of thought broadcasting, sometimes affecting behavior

5 – Severe – marked and frequent experiences of thought broadcasting, fully preoccupying the patient and regularly affecting behavior

0 – Absent

1 – Questionable pathology

2 – Mild – the patient senses the insertion of alien thoughts and expresses doubts about whether this is possible

3 – Moderate – clear, repeatedly occurring experiences of thought insertion

4 – Marked – prominent and frequent experiences of thought insertion, sometimes affecting behavior

5 – Severe – prominent and frequent experiences of thought insertion, fully dominating the patient and regularly influencing behavior

0 – absent

1 – questionable pathology

2 – mild – the patient experiences thought withdrawal by an outside force but expresses doubts that this is possible

3 – moderate – clear, recurrent phenomena of thought withdrawal occurring several times

4 – marked and frequent experiences of thought withdrawal, sometimes affecting the patient’s behavior

5 – severe – marked and frequent phenomena of thought withdrawal that fully dominate the patient’s personality and regularly influence behavior

0 – Absent

1 – Questionable pathology

2 – Mild – Delusional ideas are present, but the patient sometimes questions whether they are real.

3 – Moderate – The patient shows clear conviction in the delusional ideas, which may be brought up frequently and sometimes affect behavior.

4 – Marked – The patient is absolutely convinced of the delusional ideas, which are often brought up and affect the patient’s behavior.

5 – Severe – Delusional ideas are elaborate and systematized, encompass the patient’s entire environment, and almost completely determine behavior; they are often bizarre or fantastic in content, but the patient is absolutely convinced they are true.

0 – absent

1 – questionable pathology

2 – mild – at times, the person’s clothing or appearance seems overly original

3 – moderate – clothing or appearance is clearly odd and draws others’ attention (e.g., shaved head)

4 – marked – frankly bizarre (affected) appearance or manner of dress (examples above)

5 – severe – appearance or clothing is completely bizarre (inappropriate) or extravagant (e.g., dresses like Napoleon)

0 – Absent.

1 – Questionable pathology.

2 – Mild – occasional instances of strange (conspicuous) behavior.

3 – Moderate – frequent episodes of strange behavior (e.g., talking loudly in public).

4 – Marked – behavior is clearly bizarre (e.g., public masturbation).

5 – Severe – behavior is extremely eccentric or completely bizarre (e.g., urinating into a sugar bowl).

0 – Absent

1 – Questionable pathology

2 – Mild – isolated incidents of temper outbursts or aggressiveness

3 – Moderate – clear irritability and aggressiveness (e.g., writes angry letters to strangers)

4 – Marked – obvious anger and aggressiveness (e.g., publicly threatens or insults people)

5 – Severe – extremely aggressive and agitated (e.g., abuses animals, gets into fights, etc.)

0 – Absent

1 – Questionable pathology

2 – Mild – infrequent, brief periods of repetitive or stereotyped behavior

3 – Moderate – definite periods of repetitive or stereotyped behavior (e.g., habitual dressing or eating rituals without symbolic meaning)

4 – Marked – pronounced periods of repetitive or stereotyped behavior (e.g., eating and other rituals with symbolic meaning)

5 – Severe – extreme repetitive or stereotyped behavior (e.g., keeps a diary in an incomprehensible language)

0 – Absent

1 – Questionable pathology

2 – Mild – several episodes of bizarre behavior, with some insight

3 – Moderate – periods of odd behavior clearly deviating from accepted social norms, with some insight possible

4 – Marked – bizarre behavior clearly deviating from accepted social norms, with only vague insight

5 – Severe – behavior extremely absurd or extravagant, with no insight; may be expressed as a single act of an extreme nature (e.g., an attempt at self-mutilation or homicide)

0 – Absent.

1 – Questionable pathology.

2 – Mild – occasional derailments with minimal deviation from the topic of conversation.

3 – Moderate – multiple episodes of derailment; at times it can be difficult to understand what the patient was trying to say.

4 – Marked – frequent derailments; for much of the interview it is difficult to understand what the patient is saying; the interview is impeded.

5 – Severe – very frequent (virtually continuous) and marked derailments; the patient’s speech is almost completely incomprehensible; a productive interview is not possible.

0 – Absent

1 – Questionable pathology

2 – Mild – one or two vague replies to a question

3 – Moderate – several tangential replies

4 – Marked – frequent tangential replies; interviewing the patient is markedly difficult

5 – Severe – replies are so lacking in content that a productive interview is virtually impossible

0 – Absent

1 – Questionable pathology

2 – Mild – occasional incoherence in speech

3 – Moderate – frequent incoherence in speech

4 – Marked – a substantial portion of speech is incomprehensible

5 – Severe – most speech is incomprehensible

0 – None

1 – Questionable pathology

2 – Mild – occasional evidence of paralogical thinking

3 – Moderate – frequent evidence of paralogical thinking

4 – Marked – a significant portion of speech is illogical

5 – Severe – most speech is illogical

0 – absent

1 – questionable pathology

2 – mild – occasional episodes of excessive circumstantiality

3 – moderate – frequent episodes of excessive circumstantiality

4 – marked – a substantial portion of speech is characterized by circumstantial responses

5 – severe – most speech is filled with circumstantial elaboration

0 – Absent.

1 – Questionable pathology.

2 – Mild – intermittent logorrhea (i.e., episodic increase in pressure of speech) with slight acceleration of speech and increased loudness.

3 – Moderate – moderately marked logorrhea; the patient needs several minutes to answer a simple question; may speak spontaneously with little participation from the interviewer; speaks rapidly and loudly.

4 – Marked logorrhea; the patient needs at least three minutes to answer a simple question; speaks spontaneously without prompting; difficult to interrupt.

5 – Severe – extremely marked logorrhea; the patient talks continuously and cannot be interrupted; tries to talk over others.

0 – Absent

1 – Questionable pathology

2 – Mild – the patient was distracted once during the interview

3 – Moderate – the patient was distracted 2–4 times during the interview

4 – Marked – the patient was distracted 5–10 times during the interview

5 – Severe – the patient was distracted more than 10 times during the interview

0 – none

1 – questionable pathology

2 – mild – clang associations were noted once during the interview

3 – moderate – clang associations were noted 2–4 times during the interview

4 – marked – clang associations were noted 5–10 times during the interview

5 – severe – clang associations were noted more than 10 times during the interview, or so frequently that understanding the patient is difficult

0 – absent

1 – questionable pathology

2 – mild – occasional manifestations, but the patient’s speech remains understandable

3 – moderate – frequent manifestations; the patient is sometimes difficult to understand

4 – marked thought disorder; the patient is often difficult to understand

5 – severe – thought disorder is so marked that the patient’s speech is incomprehensible