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Mov Disord. 2019 Jun;34(6):791-798. doi: 10.1002/mds.27689. Epub 2019 May 28.

Scales to assess impulsive and compulsive behaviors in Parkinson's disease: Critique and recommendations.

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Department of Neurology, the Royal Melbourne Hospital, Parkville, Australia.
Kings College London, Institute of Psychiatry, Section of Cognitive Neuropsychiatry, London, UK.
Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Parkinson's Disease and Mental Illness Research, Education and Clinical Centers (Philadelphia Parkinson's Disease Research, Education and Clinical Center (PADRECC) and Mental Illness Research Education Clinical, Centers of Excellence (MIRECC)), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA.
Division of Neurology, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Department of Neurology, Bon Secours Hospital, Cork, Ireland.
Department of Psychiatry, University of Cambridge, Cambridge, UK.
Movement Disorders Center, Department of Neurology, University Hospital (Inselspital) and University of Bern, Bern Switzerland.
Cure Huntington's Disease InitiativeEl (CHDI) Management/CHDI Foundation, Princeton, New Jersey, USA.
Department of Neurology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
Department of Psychiatry, Maastricht University Medical Center, Maastricht, The Netherlands.
National Center of Epidemiology and Centro de Investigacion Biomedica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Carlos III Institute of Health, Madrid, Spain.
Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA.
Department of Clinical Neurosciences, Institute of Neurology, University College London, London, UK.


Impulse control disorders (ICDs) and related impulsive and compulsive behaviors (together called ICBs) have been increasingly recognized in the context of Parkinson's disease (PD) and treatment. The International Parkinson's and Movement Disorder Society commissioned a task force to assess available clinical screening instruments and rating scales, including their clinimetric properties, make recommendations regarding their utility, and suggest future directions in scale development and validation. The literature was systematically searched for scales measuring a range of reported ICBs in PD. A scale was designated "recommended" if the scale had been employed in PD studies, been used beyond the group that developed it, and had adequate clinimetric data published for PD. Numerous diagnostic screening tools and severity rating scales were identified for a range of ICBs, including compulsive medication use, punding/hobbyism, walkabout, pathological gambling, hypersexuality, compulsive or binge eating, compulsive buying, reckless driving, compulsive exercise, pyromania, trichotillomania, hoarding, kleptomania, intermittent explosive disorder, and internet addiction. For screening across the range of ICBs (except compulsive medication use), the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's disease (QUIP) and QUIP-Rating Scale (QUIP-RS) are recommended, and for severity rating across the range of ICBs the QUIP-RS and the Ardouin Scale of Behavior in Parkinson's Disease are recommended. The Scale for Outcomes in Parkinson's Disease-Psychiatric Complications is recommended for rating of hypersexuality and the compulsive behaviors gambling/shopping. Further testing of established scales against gold standard diagnostic criteria is urgently required for all other individual ICBs in PD. © 2019 International Parkinson and Movement Disorder Society © 2019 International Parkinson and Movement Disorder Society.


Parkinson's disease; clinimetrics; impulse control disorders; rating scales; reliability; validity


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