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2 results

  • The Brazilian version of the Neuropsychiatric Inventory-Clinician rating scale (NPI-C): reliability and validity in dementia

  • Florindo Stella, Orestes Vicente Forlenza, Jerson Laks, Larissa Pires de Andrade, Michelle A. Ljubetic Avendaño, Elisandra Villela Gasparetto Sé, João de Castilho Cação, Constantine G. Lyketsos, Kate de Medeiros
  • Journal:
    International Psychogeriatrics / Volume 25 / Issue 9 / September 2013
    Published online by Cambridge University Press:
    14 June 2013, pp. 1503-1511
  • Background:

    Patients with dementia may be unable to describe their symptoms, and caregivers frequently suffer emotional burden that can interfere with judgment of the patient's behavior. The Neuropsychiatric Inventory-Clinician rating scale (NPI-C) was therefore developed as a comprehensive and versatile instrument to assess and accurately measure neuropsychiatric symptoms (NPS) in dementia, thereby using information from caregiver and patient interviews, and any other relevant available data. The present study is a follow-up to the original, cross-national NPI-C validation, evaluating the reliability and concurrent validity of the NPI-C in quantifying psychopathological symptoms in dementia in a large Brazilian cohort.

    Methods:

    Two blinded raters evaluated 312 participants (156 patient-knowledgeable informant dyads) using the NPI-C for a total of 624 observations in five Brazilian centers. Inter-rater reliability was determined through intraclass correlation coefficients for the NPI-C domains and the traditional NPI. Convergent validity included correlations of specific domains of the NPI-C with the Brief Psychiatric Rating Scale (BPRS), the Cohen-Mansfield Agitation Index (CMAI), the Cornell Scale for Depression in Dementia (CSDD), and the Apathy Inventory (AI).

    Results:

    Inter-rater reliability was strong for all NPI-C domains. There were high correlations between NPI-C/delusions and BPRS, NPI-C/apathy-indifference with the AI, NPI-C/depression-dysphoria with the CSDD, NPI-C/agitation with the CMAI, and NPI-C/aggression with the CMAI. There was moderate correlation between the NPI-C/aberrant vocalizations and CMAI and the NPI-C/hallucinations with the BPRS.

    Conclusion:

    The NPI-C is a comprehensive tool that provides accurate measurement of NPS in dementia with high concurrent validity and inter-rater reliability in the Brazilian setting. In addition to universal assessment, the NPI-C can be completed by individual domains.

  • 25 - Biological treatments: general considerations

  • from Section 5 - Treatments in Psychiatry
  • Edited by Robin M. Murray, King's College London, Kenneth S. Kendler, Virginia Commonwealth University, Peter McGuffin, University of Wales College of Medicine, Simon Wessely, Institute of Psychiatry, London, David J. Castle, University of Melbourne
  • Book:
    Essential Psychiatry
    Published online:
    22 August 2009
    Print publication:
    18 September 2008, pp 567-585

  • Summary

    A neuropsychiatric assessment is no more or less than a good psychiatric assessment, comprising a psychiatric and medical history. Electrodiagnostic techniques have an important role in neuropsychiatric diagnosis. Magneto-encephalography (MEG) measures the small magnetic fields generated by neuronal currents and may be regarded as the magnetic counterpart of the electroencephalograms (EEG). Neuroimaging techniques can be broadly divided into structural and functional. The two major techniques of structural imaging are computed tomography (CT) and magnetic resonance imaging (MRI). Functional imaging techniques are used primarily to provide information on metabolism, blood flow, neurochemistry or activity of the brain. Mental disorder is characterised by the presence of mental symptoms that are judged to be the direct physiological consequence of a general medical condition. The essential features are prominent hallucinations or delusions that are judged to be due to the direct physiological effects of the medical condition or substance.