Discussion 5

Extract

Numerous rating scales are available to assess specific behavioral and psychological symptoms of dementia (BPSD) and BPSD in general. One of the most commonly used scales is the Brief Psychiatric Rating Scale (BPRS), which was developed nearly 40 years ago and has been partially validated for use in patients with dementia. Dr. Tariot commented that use of the BPRS requires extensive clinical training to conduct the semistructured interviews and to probe, gauge, and weigh data in a way that reflects clinical reasoning, thinking, and judgment. In contrast, a scale such as the Neuropsychiatric Inventory, which covers a broad spectrum of BPSD, can be administered by a healthcare professional without extensive clinical training; this is both a strength and a weakness. Dr. Sultzer recognized the value of both types of scales, those that require semistructured interviews and those that are largely observational, and suggested that using different combinations of scales in research studies may be valuable. Although the BPRS is an older scale that some researchers believe is inappropriate for use in patients with dementia, Dr. Mintzer noted that the BPRS and its subscales have been used successfully over the past few years to differentiate drug effects from placebo in this patient population.