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As described in the chapter "Schizophrenia Spectrum and Other Psychotic Disorders,” psychotic disorders are heterogeneous, and symptom severity can predict important as- pects of the illness, such as the degree of cognitive and / or neurobiological deficits. Dimen- sional assessments capture meaningful variation in the severity of symptoms, which may help with treatment planning, prognostic decision-making, and research on pathophysi- ological mechanisms. The Clinician-Rated Dimensions of Psychosis Symptom Severity provides scales for the dimensional assessment of the primary symptoms of psychosis, in- cluding hallucinations, delusions, disorganized speech, abnormal psychomotor behavior, and negative symptoms. A scale for the dimensional assessment of cognitive impairment is also included. Many individuals with psychotic disorders have impairments in a range of cognitive domains, which predict functional abilities. In addition, scales for dimensional assessment of depression and mania are provided, which may alert clinicians to mood pa- thology. The severity of mood symptoms in psychosis has prognostic value and guides treatment.
The Clinician—Rated Dimensions of Psychosis Symptom Severity is an 8-item measure that may be completed by the clinician at the time of the clinical assessment. Each item asks the clinician to rate the severity of each symptom as experienced by the individual during the past 7 days.
Each item on the measure is rated on a 5-point scale (0=none; 1=equivoca1; 2=present, but mild; 3=present and moderate; and 4=present and severe) with a symptom-specific defi- nition of each rating level. The clinician may review all of the individual’s available infor- mation and, based on clinical judgment, select (by circling) the level that most accurately describes the severity of the individual’s condition. The clinician then indicates the score for each item in the ”Score” column provided.
Frequency of Use
To track changes in the individual’s symptom severity over time, the measure may be completed at regular intervals as clinically indicated, depending on the stability of the in- dividual’s symptoms and treatment status. Consistently high scores on a particular do- main may indicate significant and problematic areas for the individual that might warrant further assessment, treatment, and follow-up. Clinical judgment should guide decision making.