About this tool
- •The SAPAS is an 8-item, free, validated screening tool for personality-pattern features that may benefit from specific therapeutic approaches.
- •It measures long-standing patterns of thinking, relating, and emotional regulation — not recent mood or stress.
- •A score of 3 or higher suggests personality-pattern features worth discussing with a clinician — particularly relevant if standard antidepressants haven't produced sufficient response.
- •A high SAPAS score is NOT a diagnosis of "personality disorder" — that term carries stigma and the test isn't precise enough for diagnosis. It's a signal that targeted therapies (DBT, schema therapy, mentalization-based therapy) may be more useful than SSRIs alone.
- •Personality-pattern features often co-occur with depression and anxiety and can affect how well standard treatments work. Recognizing the pattern is a clinical advantage, not a label.
- •SAPAS was developed by Moran, Leese, Lee, Walters, Thornicroft, and Mann (2003) and is in the public domain — anyone can use it for free.
Take the SAPAS
These questions ask about long-standing patterns — how you generally are, not just how you've been feeling recently. Answer yes or no based on what describes you across most of your life.
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Your answers are processed in your browser. Nothing is saved or sent to anyone — including Tovani — until you choose to.
Frequently asked
Does a high score mean I have a personality disorder?
No. The SAPAS is a screening tool, not a diagnostic instrument. A score of 3+ is a signal that personality-pattern features may be present — only a clinician trained in personality assessment can make any diagnosis. "Personality disorder" is also a stigma-loaded clinical term; the patterns it describes are common, treatable, and don't define who you are.
Why does this matter if I'm here for depression treatment?
Personality-pattern features often co-occur with depression and anxiety, and affect how well standard treatments work. Patients with strong patterns who get SSRIs alone often improve less than those who add personality-pattern-aware therapy (DBT, schema therapy, MBT). Recognizing the pattern lets your clinician choose more effective combinations rather than cycling through medications that aren't addressing the full picture.
What does "long-standing pattern" actually mean?
Patterns of thinking, relating, and emotional regulation that have been present across most of your life — not just during a current depressive episode. The SAPAS is asking "how are you in general" not "how have you been the past 2 weeks" (which is what the PHQ-9 and GAD-7 ask). Patterns that started in adolescence or early adulthood and persist across different life situations are what the screening targets.
Can ketamine help if I score high on this?
Ketamine treats depression and anxiety effectively regardless of co-occurring personality patterns, but personality-pattern features are best addressed through specific therapy approaches (DBT, schema therapy, mentalization-based therapy). The strongest pattern: use ketamine for the mood symptoms, use targeted therapy for the long-standing patterns. Many patients find that resolving the acute depression with ketamine makes therapy more productive.
I scored high but I don't feel like there's anything wrong with me.
That's actually a common SAPAS result — these patterns often feel like "just who I am" rather than something abnormal. The clinical question isn't whether they're wrong; it's whether they're making your life harder than it needs to be. If you're here, something probably prompted that — and personality-pattern-aware therapy can help with that something without requiring you to feel "fixed."
References
- Murrough JW et al. 2013, American Journal of Psychiatry. Ketamine RCT in treatment-resistant depression — 64% response vs 28% placebo, including patients with complex psychiatric histories where personality-pattern features often co-occur. PMID 23982301
- Sanacora G et al. 2017, JAMA Psychiatry. APA consensus on ketamine's role in treatment-resistant depression including patients with complex presentations — addressing the mood/depression component while therapy targets long-standing patterns. PMID 28249076