title: Manual for the Extrapyramidal Symptom Rating Scale (ESRS).
abstract: The Extrapyramidal Symptom Rating Scale (ESRS) was developed to assess four types of drug-induced movement disorders (DIMD): Parkinsonism, akathisia, dystonia, and tardive dyskinesia (TD). Comprehensive ESRS definitions and basic instructions are given. Factor analysis provided six ESRS factors: 1) hypokinetic Parkinsonism; 2) orofacial dyskinesia; 3) trunk/limb dyskinesia; 4) akathisia; 5) tremor; and 6) tardive dystonia. Two pivotal studies found high inter-rater reliability correlations in both antipsychotic-induced movement disorders and idiopathic Parkinson disease. For inter-rater reliability and certification of raters, >or=80% of item ratings of the complete scale should be +/-1 point of expert ratings and >or=70% of ratings on individual items of each ESRS subscale should be +/-1 point of expert ratings. During a cross-scale comparison, AIMS and ESRS were found to have a 96% (359/374) agreement between TD-defined cases by DSM-IV TD criteria. Two recent international studies using the ESRS included over 3000 patients worldwide and showed an incidence of TD ranging from 10.2% (2000) to 12% (1998). ESRS specificity was investigated through two different approaches, path analyses and ANCOVA PANSS factors changes, which found that ESRS measurement of drug-induced EPS is valid and discriminative from psychiatric symptoms.
authors.affiliation: Clinical Psychopharmacology Unit, Allan Memorial Institute, McGill University Health Centre, and Department of Psychiatry, McGill University, Montreal, QC, Canada, H3A 1A1. psychopharm.unit@mcgill.ca
authors.forename: Guy
authors.initials: G
authors.lastname: Chouinard
authors.forename: Howard C
authors.initials: HC
authors.lastname: Margolese
mesh_terms: D001480:Basal Ganglia Diseases / Q000175:diagnosis* / Q000453:epidemiology; D005149:Facial Expression; D005163:Factor Analysis, Statistical; D005684:Gait; D006801:Humans; D018476:Hypokinesia / Q000453:epidemiology; D008370:Manuals as Topic; D009127:Muscle Rigidity / Q000453:epidemiology; D011187:Posture; D012720:Severity of Illness Index; D013060:Speech; D011795:Surveys and Questionnaires; D014202:Tremor / Q000453:epidemiology; D014705:Verbal Behavior