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Validation of the questionnaire for impulsive-compulsive disorders in Parkinson's disease

Authors

  • Daniel Weintraub MD,

    Corresponding author
    1. Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    2. Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    3. Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
    4. Mental Illness Research, Education and Clinical Center (MIRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
    • 3615 Chestnut St., Room 330; Philadelphia, PA 19104-2676
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  • Staci Hoops BA,

    1. Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • Judy A. Shea PhD,

    1. Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    2. Center for Health Equity Research and Promotion (CHERP), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
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  • Kelly E. Lyons PhD,

    1. Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA
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  • Rajesh Pahwa MD,

    1. Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA
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  • Erika D. Driver-Dunckley MD,

    1. Department of Neurology, Mayo Clinic Scottsdale, Scottsdale, Arizona, USA
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  • Charles H. Adler MD, PhD,

    1. Department of Neurology, Mayo Clinic Scottsdale, Scottsdale, Arizona, USA
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  • Marc N. Potenza MD, PhD,

    1. Department of Psychiatry, Yale University, New Haven, Connecticut, USA
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  • Janis Miyasaki MD, MEd, FRCPC,

    1. Division of Neurology, University of Toronto, Toronto, Canada
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  • Andrew D. Siderowf MD, MSCE,

    1. Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • John E. Duda MD,

    1. Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    2. Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
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  • Howard I. Hurtig MD,

    1. Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • Amy Colcher MD,

    1. Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • Stacy S. Horn DO,

    1. Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • Matthew B. Stern MD,

    1. Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    2. Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
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  • Valerie Voon MD

    1. National Institute of Neurological Disorders and Stroke (NINDS), Bethesda, Maryland, USA
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  • Potential conflict of interest: None reported.

  • The QUIP is copyright-protected by the University of Pennsylvania. Use of the QUIP in investigational studies sponsored in whole or part by for-profit enterprises or for commercial purposes by any entities is prohibited without express written consent of the University of Pennsylvania.

Abstract

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. © 2009 Movement Disorder Society

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