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La maladie de Parkinson au Canada (serveur d'exploration)

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Comparing three screening tools for drug-induced parkinsonism in patients with advanced schizophrenia: A pilot study

Identifieur interne : 000A57 ( PascalFrancis/Curation ); précédent : 000A56; suivant : 000A58

Comparing three screening tools for drug-induced parkinsonism in patients with advanced schizophrenia: A pilot study

Auteurs : Pierre J. Blanchet [Canada] ; Louise Normandeau [Canada] ; Pierre H. Rompre [Canada]

Source :

RBID : Pascal:12-0228636

Descripteurs français

English descriptors

Abstract

Background: Drug-induced parkinsonism (DIP) is seen in one third of patients exposed to antipsychotic drugs and may lead to complications related to dysphagia and falls. Aside from skilled neurological examination, no tool has been validated to facilitate detection and follow-up. Objective: In this pilot study, three validated screening instruments were tested in an age-biased cohort of schizophrenia patients, including four items of the Liverpool University Neuroleptic Side-Effects Rating Scale (LUNSERS) and two brief questionnaires designed for community survey of parkinsonism. Method: Fifty-six subjects living with chronic schizophrenia between 50 and 75 years of age underwent a motor evaluation along the original Unified Parkinson's Disease Rating Scale-section III and answered questions along the selected screening instruments, and results compared to those of 16 patients with Parkinson's disease (PD) and 15 neurologically unimpaired volunteers. Odds ratios, sensitivity, specificity, and their 95% confidence intervals, were calculated. Results: All three screening instruments correctly identified the PD state and distinguished PD from healthy participants. Eighteen (32%) schizophrenic patients displayed objective motor signs of parkinsonism. A single item of the LUNSERS (shakiness) significantly distinguished DIP from DIP-free patients, with a sensitivity of 61.1% and a specificity of 83.3%. The positive predictive value was 63.5% and the negative predictive value was 81.9%. The two other screening methods showed insufficient predictive value. Conclusion: Apart from a single query on shakiness, none of the tools examined were adequate to screen for DIP in patients treated for schizophrenia. A different instrument is necessary to monitor this important adverse effect in schizophrenia. .
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A08 01  1  ENG  @1 Comparing three screening tools for drug-induced parkinsonism in patients with advanced schizophrenia: A pilot study
A11 01  1    @1 BLANCHET (Pierre J.)
A11 02  1    @1 NORMANDEAU (Louise)
A11 03  1    @1 ROMPRE (Pierre H.)
A14 01      @1 Faculty of Dental Medicine, University of Montreal @2 Montreal @3 CAN @Z 1 aut. @Z 3 aut.
A14 02      @1 University of Montreal Hospital Center (C.H.U. Montreal) @3 CAN @Z 1 aut.
A14 03      @1 Louis-H. Lafontaine Hospital @3 CAN @Z 1 aut. @Z 2 aut.
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C01 01    ENG  @0 Background: Drug-induced parkinsonism (DIP) is seen in one third of patients exposed to antipsychotic drugs and may lead to complications related to dysphagia and falls. Aside from skilled neurological examination, no tool has been validated to facilitate detection and follow-up. Objective: In this pilot study, three validated screening instruments were tested in an age-biased cohort of schizophrenia patients, including four items of the Liverpool University Neuroleptic Side-Effects Rating Scale (LUNSERS) and two brief questionnaires designed for community survey of parkinsonism. Method: Fifty-six subjects living with chronic schizophrenia between 50 and 75 years of age underwent a motor evaluation along the original Unified Parkinson's Disease Rating Scale-section III and answered questions along the selected screening instruments, and results compared to those of 16 patients with Parkinson's disease (PD) and 15 neurologically unimpaired volunteers. Odds ratios, sensitivity, specificity, and their 95% confidence intervals, were calculated. Results: All three screening instruments correctly identified the PD state and distinguished PD from healthy participants. Eighteen (32%) schizophrenic patients displayed objective motor signs of parkinsonism. A single item of the LUNSERS (shakiness) significantly distinguished DIP from DIP-free patients, with a sensitivity of 61.1% and a specificity of 83.3%. The positive predictive value was 63.5% and the negative predictive value was 81.9%. The two other screening methods showed insufficient predictive value. Conclusion: Apart from a single query on shakiness, none of the tools examined were adequate to screen for DIP in patients treated for schizophrenia. A different instrument is necessary to monitor this important adverse effect in schizophrenia. .
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Pascal:12-0228636

Le document en format XML

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<s0>Pharmacothérapie</s0>
<s5>08</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG">
<s0>Pharmacotherapy</s0>
<s5>08</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA">
<s0>Farmacoterapia</s0>
<s5>08</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE">
<s0>Antipsychotique</s0>
<s5>09</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG">
<s0>Antipsychotic</s0>
<s5>09</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA">
<s0>Antipsicótico</s0>
<s5>09</s5>
</fC03>
<fC03 i1="10" i2="X" l="FRE">
<s0>Homme</s0>
<s5>18</s5>
</fC03>
<fC03 i1="10" i2="X" l="ENG">
<s0>Human</s0>
<s5>18</s5>
</fC03>
<fC03 i1="10" i2="X" l="SPA">
<s0>Hombre</s0>
<s5>18</s5>
</fC03>
<fC03 i1="11" i2="X" l="FRE">
<s0>Psychotrope</s0>
<s2>FX</s2>
<s5>31</s5>
</fC03>
<fC03 i1="11" i2="X" l="ENG">
<s0>Psychotropic</s0>
<s2>FX</s2>
<s5>31</s5>
</fC03>
<fC03 i1="11" i2="X" l="SPA">
<s0>Psicotropo</s0>
<s2>FX</s2>
<s5>31</s5>
</fC03>
<fC03 i1="12" i2="X" l="FRE">
<s0>Enquête pilote</s0>
<s4>INC</s4>
<s5>86</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE">
<s0>Traitement</s0>
</fC07>
<fC07 i1="01" i2="X" l="ENG">
<s0>Treatment</s0>
</fC07>
<fC07 i1="01" i2="X" l="SPA">
<s0>Tratamiento</s0>
</fC07>
<fC07 i1="02" i2="X" l="FRE">
<s0>Pathologie du système nerveux</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="ENG">
<s0>Nervous system diseases</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA">
<s0>Sistema nervioso patología</s0>
<s5>37</s5>
</fC07>
<fC07 i1="03" i2="X" l="FRE">
<s0>Pathologie de l'encéphale</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG">
<s0>Cerebral disorder</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA">
<s0>Encéfalo patología</s0>
<s5>38</s5>
</fC07>
<fC07 i1="04" i2="X" l="FRE">
<s0>Syndrome extrapyramidal</s0>
<s5>39</s5>
</fC07>
<fC07 i1="04" i2="X" l="ENG">
<s0>Extrapyramidal syndrome</s0>
<s5>39</s5>
</fC07>
<fC07 i1="04" i2="X" l="SPA">
<s0>Extrapiramidal síndrome</s0>
<s5>39</s5>
</fC07>
<fC07 i1="05" i2="X" l="FRE">
<s0>Maladie dégénérative</s0>
<s5>40</s5>
</fC07>
<fC07 i1="05" i2="X" l="ENG">
<s0>Degenerative disease</s0>
<s5>40</s5>
</fC07>
<fC07 i1="05" i2="X" l="SPA">
<s0>Enfermedad degenerativa</s0>
<s5>40</s5>
</fC07>
<fC07 i1="06" i2="X" l="FRE">
<s0>Pathologie du système nerveux central</s0>
<s5>41</s5>
</fC07>
<fC07 i1="06" i2="X" l="ENG">
<s0>Central nervous system disease</s0>
<s5>41</s5>
</fC07>
<fC07 i1="06" i2="X" l="SPA">
<s0>Sistema nervosio central patología</s0>
<s5>41</s5>
</fC07>
<fC07 i1="07" i2="X" l="FRE">
<s0>Psychose</s0>
<s5>42</s5>
</fC07>
<fC07 i1="07" i2="X" l="ENG">
<s0>Psychosis</s0>
<s5>42</s5>
</fC07>
<fC07 i1="07" i2="X" l="SPA">
<s0>Psicosis</s0>
<s5>42</s5>
</fC07>
<fN21>
<s1>177</s1>
</fN21>
<fN44 i1="01">
<s1>OTO</s1>
</fN44>
<fN82>
<s1>OTO</s1>
</fN82>
</pA>
</standard>
</inist>
</record>

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