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Scale for the Assessment of Positive Symptoms (SAPS)3

Scale for the Assessment of Positive Symptoms (SAPS) Test

In about 7 minutes, the Scale for the Assessment of Positive Symptoms (SAPS) Test presents 34 questions about hallucinations, delusions, unusual behavior, and disorganized thought. Its result indicates the apparent severity of positive symptoms and offers a structured starting point for self-reflection and discussion.

Questions: 347 minutes

Scale for the Assessment: situation and reply bubbles

October 2, 2025October 2, 2025Material has been updatedOctober 2, 2025Material has been published

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Daniel Hall Psychologist · Test reviewer

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Scale Explorer

How the Scales are Structured

Thought DisorderTD

Assesses the clinician’s overall impression of the severity of formal thought disturbances.

example score2/5

2/5Moderateexample score

0 – 1Low

2 – 3Moderate

4 – 5High

A score of 2 indicates a moderate level of thought disorder severity based on observed and reported speech and thinking patterns.

Bizarre BehaviorBB

Assesses the clinician’s overall impression of the severity and significance of unusual behavioral disturbances observed during the evaluation.

example score0/2

0/2Noneexample score

0None

1 – 2Present

A score of 0 indicates no unusual behavioral disturbances were observed as clinically significant during the assessment.

DelusionsD

Assesses the overall presence and impact of delusional (nonsensical) ideas on the patient’s condition and behavior.

example score0/0

0/0Absentexample score

0Absent

0Present

A score of 0 indicates no observable delusional content or impact was noted on this scale at the time of assessment.

HallucinationsH

This scale rates the clinician’s overall impression of the severity and clinical significance of hallucination-related symptoms based on interview and observation.

example score0/0

0/0Noneexample score

0None

0Not applicable

A score of 0 indicates no hallucinatory symptoms were observed or reported as clinically significant during the assessment.

Total Summary ScoreTSS

This scale reflects the clinician’s overall judgment of the severity of positive symptoms based on observed and reported manifestations.

example score13/20

13/20Moderateexample score

0 – 6Low

7 – 13Moderate

14 – 20High

A score of 13 falls in the Moderate range, indicating a clinician-rated moderate overall severity of positive symptoms.

Subtotal ScoreSS

This scale sums SAPS intermediate ratings to quantify the overall severity of observed positive symptoms.

example score92/150

92/150Moderateexample score

0 – 50Low

51 – 100Moderate

101 – 150High

A total score of 92 falls in the Moderate range, indicating a moderately elevated overall severity of positive symptoms on the summed SAPS ratings.

Thought DisorderTD

Assesses the severity of positive thought disorder symptoms reflected in disorganized speech and disturbed associations.

example score19/40

19/40Moderateexample score

0 – 13Low

14 – 26Moderate

27 – 40High

A score of 19 falls in the Moderate range, suggesting noticeable but not extreme disturbances in speech coherence and associative processes during assessment.

Bizarre BehaviorBB

Assesses the severity of strange, extravagant, or absurd behaviors not attributable to psychoactive substance use.

example score7/20

7/20Moderateexample score

0 – 6Low

7 – 13Moderate

14 – 20High

A score of 7 falls in the Moderate range, indicating noticeable but not severe unusual behavior that may affect functioning or interaction.

DelusionsD

Assesses the severity and functional impact of delusional (nonsensical) beliefs on thinking and behavior.

example score12/60

12/60Lowexample score

0 – 19Low

20 – 39Moderate

40 – 60High

A score of 12 falls in the Low range, suggesting delusional symptoms are present to a limited degree with relatively minor impact on thinking and behavior.

HallucinationsH

Measures the severity of hallucinatory experiences across different sensory modalities based on interview and observation.

example score10/30

10/30Moderateexample score

0 – 9None/Minimal

10 – 19Moderate

20 – 30Marked/Severe

A score of 10 falls in the Moderate range, suggesting noticeable hallucinatory symptoms that are present but not at the most intense end of the scale.

Total ScoreTS

The SAPS Total score summarizes the overall severity of observed positive symptoms such as hallucinations, delusions, disorganized speech/behavior, and unusual motor behavior.

example score121/170

121/170Highexample score

0 – 56Low

57 – 113Moderate

114 – 170High

A total score of 121 falls in the High range, indicating a high overall severity of positive symptom manifestations on this assessment.

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DATA-BASED USER COHORTS

Who Usually Takes This Test?

Psychiatrists and residents

46%OF USERS

Use it in clinical interviews to rate hallucinations, delusions, and disorganization and track changes over time.

Inpatient unit clinicians

34%OF USERS

Apply it on wards to document observable positive symptoms and support treatment planning and handoffs.

Clinical psychologists in psychosis care

20%OF USERS

Use it as a structured way to quantify positive symptoms during assessment and monitor response to therapy.

BASED ON AGGREGATED, ANONYMIZED DATA FROM TENS OF THOUSANDS OF FREUDLY USERS.

Benchmarking

See How You Compare

Once you complete the test, your results are compared with real-world data from people in your country.
Below is a preview of how scores are typically distributed across each scale.

Shaded area — where most people score

Dot — the average

You — your score lands on each curve after the test— your score, after the test

Thinking disordersTd

You?

Average1.4

Typical rangeTypical0.7 – 2

Possible0 – 5

Unusual behaviorUb

You?

Average1.2

Typical rangeTypical0.9 – 1.4

Possible0 – 2

NonsenseN

You?

Average0

Typical rangeTypical0 – 0

Possible0 – 0

HallucinationsH

You?

Average0

Typical rangeTypical0 – 0

Possible0 – 0

Total of the generalized scoresTotgs

You?

Average9.7

Typical rangeTypical6.4 – 13

Possible0 – 20

Sum of intermediate scoresSois

You?

Average41.7

Typical rangeTypical21.5 – 61.9

Possible0 – 150

Thought DisordersTD

You?

Average24.2

Typical rangeTypical18.1 – 30.4

Possible0 – 40

Unusual behaviorUb

You?

Average14.9

Typical rangeTypical12 – 17.8

Possible0 – 20

NonsenseN

You?

Average28.6

Typical rangeTypical20.2 – 36.9

Possible0 – 60

HallucinationsH

You?

Average15

Typical rangeTypical11.1 – 18.9

Possible0 – 30

Total scoreTs

You?

Average96.9

Typical rangeTypical67.5 – 126.2

Possible0 – 170

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SAMPLE QUESTIONS

Example Questions From the Test

Symptom ratings should be completed by one, or preferably two, experienced raters who are thoroughly familiar with the scale’s glossary. To minimize the influence of circadian factors on scoring, ratings should be conducted at the same time of day, preferably in the morning, immediately after breakfast.

- Absent
- Questionable pathology
- Mild – commentary occurred once or twice
- Moderate – commentary voices occur at least once a week
- Marked – frequent occurrence of commentary voices
- Severe – daily voices with a commentary content
- Absent
- Questionable
- Mild – the phenomenon has occurred at least once
- Moderate – the phenomenon occurs at least once a week
- Marked – frequent somatic or tactile hallucinations
- Severe – daily somatic or tactile hallucinations
- absent
- questionable pathology
- mild – the phenomenon occurs at least once
- moderate – visual hallucinations occur at least once a week
- marked – frequent visual hallucinations
- severe – daily visual hallucinations

These are 3 of the 34 real questions — the rest appear in the test. No sign-up needed to start.

WHAT THE TEST MEASURES

Scale for the Assessment of Positive Symptoms (SAPS) Test - Description and methodology of the test

psychopathology

schizophrenia

For readers examining psychosis-related experiences or behaviors, this questionnaire organizes several positive-symptom domains into a structured profile. The Scale for the Assessment of Positive Symptoms (SAPS) Test provides ratings for hallucinations, delusions, bizarre behavior, and formal thought disorder, alongside separate global, subtotal, and total severity summaries. Its online format reflects these rating domains but is not equivalent to a clinician’s overall judgment. As a positive symptom questionnaire, it supports focused discussion with a qualified clinician.

What This Assessment Explores

The instrument examines four connected areas: hallucinations, delusions, bizarre behavior, and formal thought disorder. Items address auditory, visual, somatic or tactile perceptions; persecutory, jealous, religious, grandiose, referential, control-related, and thought-interference beliefs; unusual appearance, aggression, repetitive actions; and pressured, distracted, or disorganized speech.

Together, hallucination and delusion items contribute to the displayed profile by capturing frequency, conviction, vividness, behavioral influence, and interview impact. Related ratings describe whether the pattern appears to involve altered perception, strongly held beliefs, behavioral disturbance, or disrupted communication.

For someone using the SAPS test, the result describes apparent severity across these domains and includes broader severity summaries. It is intended for people who want a structured description of positive-symptom experiences or observations, including those preparing for a professional conversation.

Methodology and Scientific Basis

Ratings span absent/questionable-severe. Global entries judge severity; scores rate symptoms; totals summarize.

Global ratings cover Thought Disorder 0-5 (Low 0-1; Moderate 2-3); Bizarre Behavior 0-2 (None 0-0; Present 1-2); Delusions 0-0 (Absent 0-0; Present 0-0); Hallucinations 0-0 (None 0-0; Not applicable 0-0).
Quantitative scores cover Thought Disorder 0-40 (Low 0-13; Moderate 14-26; High 27-40); Bizarre Behavior 0-20 (Low 0-6; Moderate 7-13; High 14-20); Delusions 0-60 (Low 0-19; Moderate 20-39; High 40-60); Hallucinations 0-30 (None/Minimal 0-9; Moderate 10-19; Marked/Severe 20-30).
Summaries cover Total Summary Score 0-20 (Low 0-6; Moderate 7-13; High 14-20); Subtotal Score 0-150 (Low 0-50; Moderate 51-100; High 101-150); Total Score 0-170 (Low 0-56; Moderate 57-113; High 114-170).

The unstandardized online positive symptom scale aligns conceptually with SAPS and is not an adaptation; scoring is undocumented; context affects ratings, while bands describe apparent severity, not diagnosis.

Author: Nancy C. Andreasen

Literature:

Andreasen, N. C. (1984). The Scale for the Assessment of Positive Symptoms (SAPS). Iowa City, IA: The University of Iowa Press.
Andreasen, N. C. (1990). Methods for assessing positive and negative symptoms. Modern Problems in Pharmacopsychiatry, 24, 73-88. 10.1159/000418013
Andreasen, N. C., Arndt, S., Miller, D., Flaum, M., and Nopoulos, P. (1995). Correlational studies of the Scale for the Assessment of Negative Symptoms and the Scale for the Assessment of Positive Symptoms: An overview and update. Psychopathology, 28(1), 7-17. 10.1159/000284894

Updated: 2025-10-02