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Development and evaluation of the Parkinson Psychosis Questionnaire

A screening–instrument for the early diagnosis of drug–induced psychosis in Parkinson’s disease

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Abstract

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.

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Authors and Affiliations

  1. Dept. of Neurology, Philipps–University Marburg, Rudolf–Bultmann–Straße 8, 35039, Marburg, Germany

    D. Brandstaedter, S. Spieker, T. E. Eichhorn, W. H. Oertel MD & K. Eggert

  2. Paracelsus-Elena-Clinic, Kassel, Germany

    G. Ulm

  3. Institute for Technology Assessment and Dept. of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston (MA), USA

    U. Siebert

  4. Harvard Center for Risk Analysis, Harvard School of Public Health, Boston (MA), USA

    U. Siebert

  5. Dept. of Psychiatry and Psychotherapy, Philipps–University of Marburg, Marburg, Germany

    J. C. Krieg

Authors
  1. D. Brandstaedter
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  2. S. Spieker
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  3. G. Ulm
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  4. U. Siebert
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  5. T. E. Eichhorn
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  6. J. C. Krieg
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  7. W. H. Oertel MD
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  8. K. Eggert
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Corresponding author

Correspondence to W. H. Oertel MD.

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Brandstaedter, D., Spieker, S., Ulm, G. et al. Development and evaluation of the Parkinson Psychosis Questionnaire. J Neurol 252, 1060–1066 (2005). https://doi.org/10.1007/s00415-005-0816-x

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  • DOI: https://doi.org/10.1007/s00415-005-0816-x

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