Beehler Blake, Tosin Michelle H S, Stebbins Glenn T, Goetz Christopher G
Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.
Mov Disord Clin Pract. 2025 Feb;12(2):210-214. doi: 10.1002/mdc3.14225. Epub 2024 Oct 9.
Psychosis and cognitive decline often co-occur in Parkinson's Disease (PD), which complicates assessment.
We measured agreement between patients with PD and dementia (PDD) and care partners (CPs) in their independent evaluation of PD-related psychotic symptoms.
We compared responses to a PD psychosis rating scale (SAPS-PD) in 21 dyads of patients with PDD and cognitively normal CPs. We assessed the concordance of responses using the intraclass correlation coefficient (ICC). Following the psychosis assessment, the clinician used all available information and adjudicated who provided the most reliable responses.
Dyads demonstrated poor concordance in summary scores (ICC = 0.464). Six of the nine individual items had poor agreement. The clinician adjudicated the patient's response as the more reliable in 71.4% of cases.
Although many psychotic symptoms are internal and not observable, in the context of PDD, both patient and CP inputs are valuable, but final adjudication favors patient responses.
精神病和认知衰退在帕金森病（PD）中常常同时出现，这使得评估变得复杂。
我们测量了帕金森病合并痴呆（PDD）患者与护理伙伴（CPs）在独立评估与PD相关的精神病症状时的一致性。
我们比较了21对PDD患者和认知正常的CPs对帕金森病精神病评定量表（SAPS-PD）的反应。我们使用组内相关系数（ICC）评估反应的一致性。在精神病评估之后，临床医生利用所有可用信息裁定谁提供了最可靠的反应。
两组在总分上的一致性较差（ICC = 0.464）。九个单项中有六个一致性较差。在71.4%的病例中，临床医生裁定患者的反应更可靠。
尽管许多精神病症状是内在的且不可观察到，但在PDD的情况下，患者和CP的意见都有价值，但最终裁定更倾向于患者的反应。
