Melbourne researchers have developed a brief screening questionnaire that can accurately identify Parkinson’s disease (PD) patients at risk of depression and anxiety in just two minutes.
The Brief Psychiatric Questionnaire (BPQ) consists of just four questions and is a more practical alternative to the lengthy, condition-specific questionnaires currently available to examine various neuropsychiatric facets of Parkinson’s disease, according to Dr Will Lee, a neurologist at the Alfred Hospital
Writing in the journal Parkinsons Disease, Dr Lee and colleagues say the tool is designed to address the need for a fast, self-administered, multifaceted screening tool for measuring psychiatric symptoms in high-risk patients.
They said the effectiveness of validated psychiatric symptom assessment tools was hindered by factors such as length of time required to complete the assessment, a unidimensional approach and the fact that they were not designed for Parkinson’s disease patients.
They therefore set out to develop a quick screening tool to be used prior to a full assessment.
Due to anxiety, depression and apathy being present in over 40% of Parkinson’s disease patients, the study focussed on these conditions in developing the screening questionnaire.
The questionnaire was developed in an initial cohort of 95 patients with Parkinson’s disease by measuring an initial draft of 47 questions against Geriatric Depression Scale (GDS), State Trait Anxiety Inventory (Form Y2) (STAI- Y2) and Apathy Evaluation Scale (AES).
Initial testing showed that visual analogue scores from five questions strongly correlated with the final score in the validated questionnaires, which were then examined in a second cohort of 33 patients.
Further analysis in this cohort indicated poor performance in identifying apathy, so one question was dropped, leaving four questions (see box) focused on screening for symptoms of anxiety and depression for the final questionnaire.
- Do you often feel withdrawn?
- Do you often feel that your life is empty?
- Do you worry excessively over little things?
- Do you put a lot of effort into things?
Testing in the second cohort found that the results with the questions had good correlation between predicted and actual outcomes, rated moderate to strong and highly significant (r = 0.464 − 0.733, p < 0.004).
“Through four simple questions, the BPQ is able to accurately identify patients at risk of depression and anxiety who scored highly on GDS and STAI-Y2 with good repeatability,” the authors wrote.
“Results exceeding the calculated scoring thresholds of the relevant BPQ groups should alert the clinician to further test for emerging depression and anxiety.
The added that the BPQ was not designed to be a diagnostic tool or a replacement of more detailed psychiatric assessment but rather to give the clinician a signal of emerging depression and anxiety.
“As such, we see the BPQ as a pre-consultation tool that can be reliably administered on repeated occasions to prompt further psychiatric assessment.”