Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania 19104-2676, USA.
Mov Disord. 2012 Feb;27(2):242-7. doi: 10.1002/mds.24023. Epub 2011 Dec 1.
Impulse control disorders and related disorders (hobbyism-punding and dopamine dysregulation syndrome) occur in 15% to 20% of Parkinson's disease (PD) patients. We assessed the validity and reliability of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS), a rating scale designed to measure severity of symptoms and support a diagnosis of impulse control disorders and related disorders in PD. A convenience sample of PD patients at a movement disorders clinic self-completed the QUIP-RS and were administered a semistructured diagnostic interview by a blinded trained rater to assess discriminant validity for impulse control disorders (n = 104) and related disorders (n = 77). Subsets of patients were assessed to determine interrater reliability (n = 104), retest reliability (n = 63), and responsiveness to change (n = 29). Adequate cutoff points (both sensitivity and specificity values >80% plus acceptable likelihood ratios) were established for each impulse control disorder and hobbyism-punding. Interrater and retest reliability (intraclass correlation coefficient r) were >0.60 for all disorders. Participants in an impulse control disorder treatment study who experienced full (t = 3.65, P = .004) or partial (t = 2.98, P = .01) response demonstrated significant improvement on the rating scale over time, while nonresponders did not (t = 0.12, P = .91). The QUIP-RS appears to be valid and reliable as a rating scale for impulse control disorders and related disorders in PD. Preliminary results suggest that it can be used to support a diagnosis of these disorders, as well as to monitor changes in symptom severity over time.
冲动控制障碍及相关障碍(癖好-强迫行为和多巴胺调节障碍综合征)在 15%至 20%的帕金森病(PD)患者中发生。我们评估了专为测量 PD 中冲动控制障碍及相关障碍严重程度并支持其诊断的帕金森病冲动控制障碍评定量表(QUIP-RS)的有效性和可靠性。运动障碍诊所的 PD 患者便利样本通过自我评估 QUIP-RS,并由经过培训的盲评定者进行半结构化诊断访谈,以评估冲动控制障碍(n = 104)和相关障碍(n = 77)的判别效度。评估了部分患者以确定评定者间信度(n = 104)、重测信度(n = 63)和对变化的反应性(n = 29)。为每个冲动控制障碍和癖好-强迫行为建立了足够的截断值(均>80%的敏感性和特异性值加上可接受的似然比)。所有障碍的评定者间和重测信度(组内相关系数 r)均>0.60。在冲动控制障碍治疗研究中,经历完全(t = 3.65,P =.004)或部分(t = 2.98,P =.01)反应的参与者在评分量表上随时间显著改善,而无反应者则没有(t = 0.12,P =.91)。QUIP-RS 似乎是一种有效的 PD 冲动控制障碍和相关障碍评定量表,具有可靠性。初步结果表明,它可用于支持这些障碍的诊断,以及监测随时间推移的症状严重程度变化。