Development and evaluation of the Parkinson Psychosis Questionnaire - A screening-instrument for the early diagnosis of drug-induced psychosis in Parkinson's disease

被引:41
作者
Brandstaedter, D
Spieker, S
Ulm, G
Siebert, U
Eichhorn, TE
Krieg, JC
Oertel, WH
Eggert, K
机构
[1] Univ Marburg, Dept Neurol, D-35039 Marburg, Germany
[2] Paracelsus Elena Clin, Kassel, Germany
[3] Harvard Univ, Sch Med, Massachusetts Gen Hosp, Inst Technol Assessment, Boston, MA USA
[4] Harvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Radiol, Boston, MA USA
[5] Harvard Univ, Sch Publ Hlth, Harvard Ctr Risk Anal, Boston, MA 02115 USA
[6] Univ Marburg, Dept Psychiat & Psychotherapy, Marburg, Germany
关键词
Parkinson Psychosis Questionnaire; drug-induced psychosis; Parkinson's disease; screening-instrument; BPRS; SCID;
D O I
10.1007/s00415-005-0816-x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective Drug-induced psychosis is a frequent side-effect in the treatment of advanced Parkinson's disease (PD). We sought to develop and evaluate a brief instrument for early recognition of drug-induced psychosis in PD. Methods We developed the "Parkinson Psychosis Questionnaire" (PPQ), which consists of screening questions for typical early signs and psychotic symptoms in PD and which quantifies the frequency and severity of four clinical categories-sleep disturbances, hallucinations/illusions, delusions and orientation. We performed an internal validation of the PPQ in 50 unselected patients with parkinsonism. The Brief Psychiatric Rating Scale (BPRS) and the "Structurized Clinical Interview" (SCID) for DSM IV were applied to the same patients as external references. Results Of 50 subjects, 49 suffered from idiopathic PD and one from probable MSA-P. Hoehn and Yahr stages in "on" ranged from 1.5 to 4. Sensitivity of the PPQ test for drug-induced psychosis according to SCID was 100 % (95 % CI: 73.5%, 100%); while specificity was 92.1 % (95% CI: 78.6%, 98.3 %). The PPQ severity score was highly correlated with BPRS. We derived a linear prediction formula, which transformed PPQ into BPRS scores. Conclusion The PPQ appears to be a suitable, and easily administered instrument for early diagnosis of druginduced psychosis in routine PD care. Whether the PPQ could also be a valuable tool for monitoring follow-up studies and therapeutic intervention trials remains to be tested.
引用
收藏
页码:1060 / 1066
页数:7
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