A study on the reliability and validity of CWS in Chinese schizophrenia patients

Currently, the diagnosis and assessment of schizophrenia remain challenging. This study aimed to examine the reliability and validity of the Crisi Wartegg System (CWS) for assessing schizophrenia within the Chinese cultural context, with the goal of exploring its potential as an auxiliary evaluation tool. A total of 50 individuals diagnosed with schizophrenia and 50 healthy controls were recruited. All participants completed the Wartegg Drawing Test and the Minnesota Multiphasic Personality Inventory–2 (MMPI-2), and Positive and Negative Syndrome Scale (PANSS) scores were collected from patients with schizophrenia. Inter-rater reliability of the CWS was evaluated using the intraclass correlation coefficient (ICC). Structural validity was assessed by comparing CWS indices between the schizophrenia and healthy groups, as well as by examining correlations between CWS indices and MMPI-2 scales. Criterion validity was verified by analyzing the associations between CWS indices and PANSS scores. Results indicated that the CWS demonstrated moderate to high inter-rater reliability. Significant group differences were observed in EC+%, FQ+%, P%, and P+% scores, and several CWS indices were significantly correlated with MMPI-2 scales, including F (Infrequency) and Sc (Schizophrenia), supporting its structural validity. In conclusion, the findings provide evidence for the reliability and validity of the CWS in schizophrenia assessment. CWS indices not only differentiate individuals with schizophrenia from healthy controls but also show significant correlations with selected MMPI-2 scales, further confirming its structural validity. These results establish a foundation for the application of the CWS in cross-cultural clinical practice for schizophrenia.