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  • Development and clinimetric assessment of a nurse-administered screening tool for movement disorders in psychosis

  • Bettina Balint, Helen Killaspy, Louise Marston, Thomas Barnes, Anna Latorre, Eileen Joyce, Caroline S. Clarke, Rosa De Micco, Mark J. Edwards, Roberto Erro, Thomas Foltynie, Rachael M. Hunter, Fiona Nolan, Anette Schrag, Nick Freemantle, Yvonne Foreshaw, Nicholas Green, Kailash P. Bhatia, Davide Martino
  • Journal:
    BJPsych Open / Volume 4 / Issue 5 / September 2018
    Published online by Cambridge University Press:
    27 September 2018, pp. 404-410
    • Article
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  • Background

    Movement disorders associated with exposure to antipsychotic drugs are common and stigmatising but underdiagnosed.

    Aims

    To develop and evaluate a new clinical procedure, the ScanMove instrument, for the screening of antipsychotic-associated movement disorders for use by mental health nurses.

    Method

    Item selection and content validity assessment for the ScanMove instrument were conducted by a panel of neurologists, psychiatrists and a mental health nurse, who operationalised a 31-item screening procedure. Interrater reliability was measured on ratings for 30 patients with psychosis from ten mental health nurses evaluating video recordings of the procedure. Criterion and concurrent validity were tested comparing the ScanMove instrument-based rating of 13 mental health nurses for 635 community patients from mental health services with diagnostic judgement of a movement disorder neurologist based on the ScanMove instrument and a reference procedure comprising a selection of commonly used rating scales.

    Results

    Interreliability analysis showed no systematic difference between raters in their prediction of any antipsychotic-associated movement disorders category. On criterion validity testing, the ScanMove instrument showed good sensitivity for parkinsonism (90%) and hyperkinesia (89%), but not for akathisia (38%), whereas specificity was low for parkinsonism and hyperkinesia, and moderate for akathisia.

    Conclusions

    The ScanMove instrument demonstrated good feasibility and interrater reliability, and acceptable sensitivity as a mental health nurse-administered screening tool for parkinsonism and hyperkinesia.

    Declaration of interest

    None.

Case Studies in Movement Disorders
  • Common and Uncommon Presentations
  • Kailash P. Bhatia, Roberto Erro, Maria Stamelou
  • Published online:
    04 July 2017
    Print publication:
    27 April 2017
  • Drawing on the expertise of an international team of authors, Case Studies in Movement Disorders is a compilation of illustrative cases, demonstrating a step-by-step approach to diagnosing and managing these complex conditions. An extensive collection of over sixty videos shows both common and uncommon presentations of a wide range of movement disorders, and the accompanying text guides readers systematically through the clinical history, examination and investigation findings, and diagnosis, and finally discusses the clinical issues raised. Both surgical and pharmacological management options are presented, helping readers understand some of the controversies involved in treatment. The cases are drawn from all of the major groups of movement disorders: ataxia, chorea, dystonia, myoclonus, parkinsonism, tics, and tremor. This will be invaluable for both neurologists in training and more experienced professionals seeking to develop their diagnostic skills, especially when faced with uncommon conditions or uncommon manifestations of common disorders.

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