Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland.
Neurocenter, Luzerner Kantonsspital, Luzern, Switzerland.
Neuropsychobiology. 2022;81(4):311-321. doi: 10.1159/000523778. Epub 2022 Apr 1.
Deficits in social interaction and community functioning, including impaired use, performance, and perception of hand gestures, are key features in schizophrenia. A well-established tool to assess gesture deficits is the test of upper limb apraxia (TULIA). However, given its time-consuming application based on video analyses, research has proposed the bedside apraxia screen of TULIA (AST). This study aims to test the validity and reliability of the AST to detect gesture abnormalities at bedside in a sample of 27 patients diagnosed with schizophrenia, schizotypal disorder, acute and transient psychotic disorders, or schizoaffective disorder.
Patients completed the 48-item TULIA and the 12-item AST. Two different raters assessed the AST: one at bedside (online) and the other based on the video recordings.
The total AST scores demonstrated a high parallel reliability, moderate inter-rater reliability on a single-item level, and good construct validities.
The psychometric properties of the AST suggest it can well be used for the clinical assessment of gesture deficits in schizophrenia. However, when detailed information is required, the AST rated from video or conducting the full TULIA is recommended. The findings call for refining the selection of the TULIA items for a psychosis-AST bedside test to increase specificity.
社会互动和社区功能障碍，包括手部手势的使用、表现和感知受损，是精神分裂症的主要特征。评估手势缺陷的一个成熟工具是上肢失用症测试（TULIA）。然而，由于其基于视频分析的耗时应用，研究提出了 TULIA 的床边失用症筛查（AST）。本研究旨在测试 AST 在一个由 27 名被诊断为精神分裂症、分裂型障碍、急性和短暂性精神病性障碍或分裂情感障碍的患者样本中的有效性和可靠性，以检测床边的手势异常。
患者完成了 48 项 TULIA 和 12 项 AST。两位不同的评估者评估了 AST：一位在床边（在线），另一位基于视频记录。
总 AST 评分显示出高度的平行可靠性、单项水平的中度评估者间可靠性以及良好的结构有效性。
AST 的心理测量特性表明，它可以很好地用于精神分裂症患者的手势缺陷的临床评估。然而，当需要详细信息时，建议从视频评估 AST 或进行完整的 TULIA。研究结果呼吁细化用于精神病-AST 床边测试的 TULIA 项目选择，以提高特异性。
