Scale for the Assessment of Negative Symptoms (SANS)

The SANS measures the negative symptoms of schizophrenia — not hallucinations or delusions, but the things that have gone missing. Reduced emotional expression, reduced speech, reduced motivation, reduced pleasure, reduced attention.

Twenty-five items sit in five domains. Affective flattening covers unchanging facial expression, reduced gestures, poor eye contact, and flat vocal tone. Alogia covers poverty of speech and of speech content. Avolition-apathy covers grooming, work, and physical energy. Anhedonia-asociality covers loss of interest in recreation, sex, closeness, and relationships. Attention covers inattentiveness during testing and socially. Each item is rated 0 for none to 5 for severe, and each domain also carries a global rating.

Licensing Notes: The scale is reproduced widely in trial protocols and hosted by the NIH database of Genotypes and Phenotypes.

Learn More: Total scoring is not standardised, which matters when comparing across studies. Some sum all 25 items for a 0–125 range; others exclude the five global ratings; others additionally exclude items 10, 23, 24, and 25 for a 0–85 range. State which convention you used.