PDSS

Panic Disorder Severity Scale (PDSS)
M. K. Shear, D. Barlow, T. Brown, R. Money, D. Sholomskas, S. Woods, J. Gorman, and L. Papp

Modified From: Rush J, et al: psychiatric Measures, APA, Washington, DC, 2000.
GOALS The Panic Disorder Severity Scale (PDSS) (Shear et al. 1997) was developed to provide a simple way of measuring the overall severity of DSM-IV panic disorder. It is a brief instrument intended to assess severity and monitor treatment outcome. DESCRIPTION The clinician-administered PDSS, modeled on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), provides operationalized ratings of DSM-IV panic disorder symptoms, using a scripted interview. The PDSS consists of seven items, each rated on a 5-point Likert scale. The items are carefully anchored and assess panic frequency, distress during panic, panic-focused anticipatory anxiety, phobic avoidance of situations, phobic avoidance of physical sensations, impairment in work functioning, and impairment in social functioning. A total score is calculated by summing the scores for all seven items. Individual responses are scored on a scale of 04, and total scores range from 0 to 28. PRACTICAL ISSUES Experience suggests that the scale can be administered in 510 minutes. Clinical training in the evaluation of panic disorder is recommended for effective use of the scale. Raters who use the scale for research purposes must be trained. The scale is copyrighted by the University of Pittsburgh and is available from M. Katherine Shear, M.D. Anxiety Disorders Prevention Program Western Psychiatric Institute and Clinic 3811 OHara Street Pittsburgh, PA 15213 Phone: 412-624-5500. Use is freely permitted without further permission in the following situations: clinical use in a not-for-profit institution and use in a research protocol approved by an institutional review board. All other uses require written permission from the principal author, M. Katherine Shear, M.D., including but not limited to the following: redistribution of the instrument in printed, electronic, or other forms, commercial use of the instrument, or modification of the instrument. A computerized version is being developed but is not currently available. PSYCHOMETRIC PROPERTIES Reliability Evaluation of internal consistency in 198 patients with DSM-III-R panic disorder yielded a Cronbachs alpha of 0.64. Joint reliability ranged from 0.84 to 0.88 for trained raters. Validity The PDSS total score showed moderate correlations with both panic disorder severity ratings of the Anxiety Disorders Interview ScheduleRevised (ADIS-R) (r = 0.54) (DiNardo and Barlow 1988) and severity ratings of the Clinical Global Impression (CGI) Scale (r = 0.66). Individual PDSS item scores were strongly associated (r = 0.600.78) with ADIS-R items of similar content and less strongly associated (r = 0.350.47) with CGI
Scale and ADIS-R severity ratings. The PDSS items most highly correlated with similar ADIS-R items were panic frequency (r = 0.71), anticipatory anxiety (r = 0.78), agoraphobic fear and avoidance (r = 0.73), and sensation fear and avoidance (r = 0.69). The PDSS total score was not significantly correlated with that of the Hamilton Rating Scale for Depression (Ham-D) (r = 0.11). The PDSS has proved to be sensitive to change with treatment. CLINICAL UTILITY The PDSS is a brief, clinician-administered interview rating. It is a useful way of assessing overall panic disorder severity at baseline, and it provides a profile of severity of the different panic disorder symptoms. It is a good monitoring tool because it is brief and sensitive to change. Because it is meant for use after diagnosis, it is not appropriate for screening, and it is not a diagnostic instrument. It could be used administratively to monitor the outcome of panic disorder specifically. REFERENCES AND SUGGESTED READINGS DiNardo PA, Barlow DH: Anxiety Disorders Interview Schedule, Revised (ADIS-R). Albany, NY, Phobia and Anxiety Disorders Clinic, State University of New York, 1988 Shear MK, Brown TA, Barlow DH, et al: Multicenter collaborative Panic Disorder Severity Scale. Am J Psychiatry 154:15711575, 1997

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Panic Disorder Severity Scale (PDSS)

M. K. Shear, D. Barlow, T. Brown, R. Money, D. Sholomskas, S. Woods, J. Gorman, and L. Papp

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