title: Parkinson's Impulse-Control Scale for the Severity Rating of Impulse-Control Behaviors in Parkinson's Disease: A Semistructured Clinical Assessment Tool.
abstract: Impulse-control behaviors (ICBs) are increasingly recognized in Parkinson's disease (PD) as drug-related effects of dopaminergic mediation that occur in 15% to 35% of patients with PD. The authors describe the design and evaluation of a new, clinician-rated severity scale for the assessment of syndromal and subsyndromal forms of impulse-control disorders (ICDs), simple (punding) and complex (hobbyism) repetitive behaviors, and compulsive overuse of medication (dopamine dysregulation syndrome).
  
  
  
  The Parkinson's Impulse-Control Scale (PICS), the first PD-specific, semistructured interview to cover the full range of PD-related ICBs, is described along with initial evidence on its clinimetric properties including interrater reliability, discriminant validity and sensitivity to change. A convenience sample of PD patients with ICBs and those without were administered a semistructured interview (n = 92).
  
  
  
  The scale distinguished between those with and without clinically detected ICBs and between patients with syndromal ICD and subsyndromal ICB (receiver operating characteristic areas under the curve, 92%-95%). Cutoff values were suggested, and substantial agreement was reported on weighted kappa (Κ) values for clinician-clinician rating of severity (Κ = 0.92). Significant improvements were detected on the scale after a randomized controlled trial of cognitive-behavioral therapy and medication adjustment (t[22] = 5.47;P< 0.001).
  
  
  
  The PICS appears to be a reliable measure of the full range of PD ICBs with good levels of interrater reliability. It may provide a useful measure to assess the severity of ICBs and monitor change in clinical and research settings; although, given the specialized centers used for recruitment of this sample, further psychometric evaluation is required.
authors: Section of Cognitive Neuropsychiatry Institute of Psychiatry, Psychology, and Neuroscience King's College London London United Kingdom; Department of Psychological Medicine Oxford University Hospitals NHS Trust Oxford United Kingdom.
authors: David
authors: D
authors: Okai
authors: Section of Cognitive Neuropsychiatry Institute of Psychiatry, Psychology, and Neuroscience King's College London London United Kingdom; School of Psychology Newcastle University Newcastle upon Tyne United Kingdom.
authors: Sally
authors: S
authors: Askey-Jones
authors: Portland Veterans Affairs Medical Center Portland Oregon USA.
authors: Joel
authors: J
authors: Mack
authors: King's Health Partners King's College Hospital NHS Trust London United Kingdom.
authors: Anne
authors: A
authors: Martin
authors: King's Health Partners King's College Hospital NHS Trust London United Kingdom.
authors: Kallol Ray
authors: KR
authors: Chaudhuri
authors: King's Health Partners King's College Hospital NHS Trust London United Kingdom.
authors: Michael
authors: M
authors: Samuel
authors: Section of Cognitive Neuropsychiatry Institute of Psychiatry, Psychology, and Neuroscience King's College London London United Kingdom.
authors: Anthony S
authors: AS
authors: David
authors: Department of Psychology Institute of Psychiatry, Psychology and Neuroscience King's College London London United Kingdom.
authors: Richard G
authors: RG
authors: Brown
keywords: Parkinson's disease; carer; impulse‐control disorder; rating; severity