Weintraub Daniel, Hoops Staci, Shea Judy A, Lyons Kelly E, Pahwa Rajesh, Driver-Dunckley Erika D, Adler Charles H, Potenza Marc N, Miyasaki Janis, Siderowf Andrew D, Duda John E, Hurtig Howard I, Colcher Amy, Horn Stacy S, Stern Matthew B, Voon Valerie
Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Mov Disord. 2009 Jul 30;24(10):1461-7. doi: 10.1002/mds.22571.
As no comprehensive assessment instrument for impulse control disorders (ICDs) in Parkinson's disease (PD) exists, the aim of this study was to design and assess the psychometric properties of a self-administered screening questionnaire for ICDs and other compulsive behaviors in PD. The Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP) has 3 sections: Section 1 assesses four ICDs (involving gambling, sexual, buying, and eating behaviors), Section 2 other compulsive behaviors (punding, hobbyism, and walkabout), and Section 3 compulsive medication use. For validation, a convenience sample of 157 PD patients at 4 movement disorders centers first completed the QUIP, and then was administered a diagnostic interview by a trained rater blinded to the QUIP results. A shortened instrument (QUIP-S) was then explored. The discriminant validity of the QUIP was high for each disorder or behavior (receiver operating characteristic area under the curve [ROC AUC]: gambling = 0.95, sexual behavior = 0.97, buying = 0.87, eating = 0.88, punding = 0.78, hobbyism = 0.93, walkabout = 0.79). On post hoc analysis, the QUIP-S ICD section had similar properties (ROC AUC: gambling = 0.95, sexual behavior = 0.96, buying = 0.87, eating = 0.88). When disorders/behaviors were combined, the sensitivity of the QUIP and QUIP-S to detect an individual with any disorder was 96 and 94%, respectively. Scores on the QUIP appear to be valid as a self-assessment screening instrument for a range of ICDs and other compulsive behaviors that occur in PD, and a shortened version may perform as well as the full version. A positive screen should be followed by a comprehensive, clinical interview to determine the range and severity of symptoms, as well as need for clinical management.
由于目前尚无针对帕金森病(PD)冲动控制障碍(ICD)的综合评估工具,本研究旨在设计并评估一份用于筛查PD患者ICD及其他强迫行为的自填式问卷的心理测量特性。帕金森病冲动-强迫障碍问卷(QUIP)分为3个部分:第1部分评估4种ICD(涉及赌博、性行为、购物和饮食行为),第2部分评估其他强迫行为(刻板动作、爱好成瘾和徘徊),第3部分评估强迫性用药。为进行效度验证,来自4个运动障碍中心的157例PD患者组成的便利样本首先完成QUIP问卷,然后由一名对QUIP结果不知情的经过培训的评估者进行诊断性访谈。随后探索了一个简化版问卷(QUIP-S)。QUIP对每种障碍或行为的判别效度都很高(曲线下面积[ROC AUC]:赌博=0.95,性行为=0.97,购物=0.87,饮食=0.88,刻板动作=0.78,爱好成瘾=0.93,徘徊=0.79)。事后分析显示,QUIP-S的ICD部分具有相似特性(ROC AUC:赌博=0.95,性行为=0.96,购物=0.87,饮食=0.88)。当将各种障碍/行为合并时,QUIP和QUIP-S检测出患有任何一种障碍的个体的敏感性分别为96%和94%。QUIP得分作为一种自我评估筛查工具,对于PD中出现的一系列ICD及其他强迫行为似乎是有效的,简化版的表现可能与完整版一样好。筛查结果呈阳性后,应进行全面的临床访谈,以确定症状的范围和严重程度以及临床管理的必要性。