Development and clinimetric assessment of a nurse-administered screening tool for movement disorders in psychosis
Bettina Balint,
Helen Killaspy,
Louise Marston,
Thomas Barnes,
Anna Latorre,
Eileen Joyce,
Caroline S. Clarke,
Rosa De Micco,
Mark J. Edwards,
Roberto Erro,
Thomas Foltynie,
Rachael M. Hunter,
Fiona Nolan,
Anette Schrag,
Nick Freemantle,
Yvonne Foreshaw,
Nicholas Green,
Kailash P. Bhatia,
Davide Martino
Affiliations
Bettina Balint
Neurologist, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, UK and Department of Neurology, University of Heidelberg, Germany
Helen Killaspy
Psychiatrist, Division of Psychiatry, Department of Primary Care and Population Health, University College London and Priment Clinical Trials Unit, University College London, UK
Louise Marston
Research Associate, Department of Primary Care and Population Health, University College London and Priment Clinical Trials Unit, University College London, UK
Thomas Barnes
Psychiatrist, Department of Psychiatry, Imperial College London, UK
Anna Latorre
Neurologist, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, University College London, UK and Department of Neurology and Psychiatry, Sapienza, University of Rome, Italy
Eileen Joyce
Psychiatrist, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, University College London, UK
Caroline S. Clarke
Research Associate, Department of Primary Care and Population Health and Priment Clinical Trials Unit, University College London, UK
Rosa De Micco
Neurologist, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences and MRI Research Center SUN-FISM, University of Campania ‘Luigi Vanvitelli’, Italy
Mark J. Edwards
Neurologist, Institute of Cardiovascular and Cell Sciences, St George's University, UK
Roberto Erro
Neurologist, Neurodegenerative Diseases Center (CEMAND) Department of Medicine, Surgery and Dentistry, University of Salerno, Italy
Thomas Foltynie
Neurologist, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, University College London, UK
Rachael M. Hunter
Research Associate, Department of Primary Care and Population Health, and Priment Clinical Trials Unit, University College London, UK
Fiona Nolan
Research Nurse, School of Health and Social Care, University of Essex, UK
Anette Schrag
Neurologist, Department of Clinical Neurosciences, Royal Free Campus, UCL Institute of Neurology, University College London, UK
Nick Freemantle
Statistician, Department of Primary Care and Population Health, University College London and Priment Clinical Trials Unit, University College London, UK
Yvonne Foreshaw
Research Nurse, Camden and Islington NHS Foundation Trust, St Pancras Hospital, UK
Nicholas Green
Research Nurse, Camden and Islington NHS Foundation Trust, St Pancras Hospital, UK
Kailash P. Bhatia
Neurologist, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, University College London, UK
Davide Martino
Neurologist, Department of Clinical Neurosciences, University of Calgary, Canada
BackgroundMovement disorders associated with exposure to antipsychotic drugs are common and stigmatising but underdiagnosed.AimsTo develop and evaluate a new clinical procedure, the ScanMove instrument, for the screening of antipsychotic-associated movement disorders for use by mental health nurses.MethodItem selection and content validity assessment for the ScanMove instrument were conducted by a panel of neurologists, psychiatrists and a mental health nurse, who operationalised a 31-item screening procedure. Interrater reliability was measured on ratings for 30 patients with psychosis from ten mental health nurses evaluating video recordings of the procedure. Criterion and concurrent validity were tested comparing the ScanMove instrument-based rating of 13 mental health nurses for 635 community patients from mental health services with diagnostic judgement of a movement disorder neurologist based on the ScanMove instrument and a reference procedure comprising a selection of commonly used rating scales.ResultsInterreliability analysis showed no systematic difference between raters in their prediction of any antipsychotic-associated movement disorders category. On criterion validity testing, the ScanMove instrument showed good sensitivity for parkinsonism (90%) and hyperkinesia (89%), but not for akathisia (38%), whereas specificity was low for parkinsonism and hyperkinesia, and moderate for akathisia.ConclusionsThe ScanMove instrument demonstrated good feasibility and interrater reliability, and acceptable sensitivity as a mental health nurse-administered screening tool for parkinsonism and hyperkinesia.Declaration of interestNone.
