Background WHO’s Schedules for Clinical Assessment in Neuropsychiatry (SCAN) is often used as the gold standard for psychiatric classification. We systematically reviewed studies on the psychometric properties of the SCAN to support its adaptation to the revised international classification systems.

Methods We searched PubMed, PsycINFO, Embase, Global Health, and Global Index Medicus up to April 17, 2025, and contacted experts. The protocol was registered in PROSPERO (CRD42024522395).

Results Titles and abstracts of 4,241 records were screened, with 296 full-text articles evaluated. Ninety-three articles were included in the final review: 46 assessing SCAN’s psychometric properties and 47 validating other measures using SCAN as a gold standard. The internal consistency of the SCAN and its predecessor, the Present State Examination (PSE), ranged from good to excellent. Both demonstrated acceptable intra-rater, inter-rater, and test-retest reliability, with reliability especially high for psychotic disorders. There was also evidence supporting concurrent, construct, semantic, and content validity, although there was an absence of evidence for predictive validity. We also found acceptable psychometric properties for the different syndrome-based sections of the SCAN.

Conclusion Although recent, high-quality studies are scarce, the SCAN is a promising tool for diagnosing a variety of psychiatric issues, particularly psychotic disorders. It demonstrates established reliability and evidence of concurrent, construct, semantic, and content validity. However, there is a need to revise the current version of SCAN to align it with contemporary diagnostic systems. Additionally, further research is required, especially regarding the assessment of non-psychotic conditions.

The authors have declared no competing interest.

WF and AM received support from WHO. WF and CH receive support from the Wellcome Trust through grants 222154/Z20/Z. CH receives support from NIHR through the NIHR Global Health Research Group on Homelessness and Mental Health in Africa (NIHR134325), using UK aid from the UK Government. CH also receives support from WT grant 223615/Z/21/Z. AM receives support from DELTAS Africa Initiative through the African Mental Health Research Initiative (AMARI) II project. The DELTAS Africa Initiative is a programme of the Science for Africa Foundation being implemented with support from Wellcome and the UK Foreign Commonwealth and Development Office (FCDO). The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care or WHO. For the purpose of open access, the authors have applied a Creative Commons Attribution (CC BY) licence to any Author Accepted Author Manuscript version arising from this submission.

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