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Predictors of Discrepancies in Parkinson's Disease Patient and Caregiver Ratings of Apathy, Disinhibition, and Executive Dysfunction before and after Diagnosis

Published online by Cambridge University Press:  15 January 2013

Dawn M. Schiehser ,
Lin Liu ,
Stephanie L. Lessig ,
David D. Song ,
Kristalyn M. Obtera ,
Mathes M. Burke III ,
Shannon R. Earl  and
J. Vincent Filoteo
Dawn M. Schiehser*
Affiliation:
Research Service, VA San Diego Healthcare System, San Diego, California Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, California
Lin Liu
Affiliation:
Department of Neurosciences, School of Medicine, University of California, San Diego, La Jolla, California
Stephanie L. Lessig
Affiliation:
Research Service, VA San Diego Healthcare System, San Diego, California Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, California
David D. Song
Affiliation:
Research Service, VA San Diego Healthcare System, San Diego, California Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, California
Kristalyn M. Obtera
Affiliation:
Research Service, VA San Diego Healthcare System, San Diego, California
Mathes M. Burke III
Affiliation:
Research Service, VA San Diego Healthcare System, San Diego, California
Shannon R. Earl
Affiliation:
Research Service, VA San Diego Healthcare System, San Diego, California
J. Vincent Filoteo
Affiliation:
Research Service, VA San Diego Healthcare System, San Diego, California Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, California
*
Correspondence and reprint requests to: Dawn M. Schiehser, VA San Diego Healthcare System (116B), 3350 La Jolla Village Drive, San Diego, CA 92161. E-mail: dschiehser@ucsd.edu
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Abstract

Parkinson's disease (PD) patient and caregiver reports of patient functioning are often used interchangeably in clinical and research settings; however, the consistency of these reports is largely unknown. This study aimed to investigate the consistency and predictors of discrepancy between self- and caregiver reports of patient apathy, disinhibition, and executive dysfunction. Fifty-one pairs of nondemented PD patients and their caregivers completed the Frontal Systems Behavior Scale (FrSBe). Patients were administered a neuropsychological battery, and mood and burden were assessed in a subset of caregivers. Patients and caregivers significantly differed in their ratings of all retrospective prediagnosis behaviors and current levels of disinhibition. Current levodopa equivalent dosages predicted patient-caregiver rating differences in prediagnosis and current apathy and current executive dysfunction, while patient motor function, cognition, and mood failed to predict any disparities in ratings. Caregiver burden and depression were associated with apathy rating discrepancies, while burden was associated with discrepancies in ratings of disinhibition. These results suggest that consistency of patient and caregiver behavioral ratings may vary depending on the behavior assessed; and underscore the importance of considering the reporter when using subjective measures, as discrepancies in behavioral reports may be influenced by specific patient and/or caregiver symptoms or factors. (JINS, 2013, 19, 1–10)

Keywords

BehaviorCarersCognitionExecutive functionParkinson's diseaseSelf report
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 19 , Issue 3 , March 2013 , pp. 295 - 304
Copyright
Copyright © The International Neuropsychological Society 2012

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References

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Association Press.Google Scholar
Antonini, A., Cilia, R. (2009). Behavioural adverse effects of dopaminergic treatments in Parkinson's disease: Incidence, Neurobiological basis, management and prevention. Drug Safety, 32(6), 475–488.CrossRefGoogle ScholarPubMed
Berg, E. (1948). A simple objective technique for measuring flexibility in thinking. Journal of General Psychology, 39, 15–22.CrossRefGoogle ScholarPubMed
Brown, G.G., Rahill, A.A., Gorell, J.M., McDonald, C., Brown, S.J., Sillanpaa, M., Shults, C. (1999). Validity of the Dementia Rating Scale in assessing cognitive function in Parkinson's disease. Journal Geriatric Psychiatry and Neurology, 12(4), 180–188.CrossRefGoogle ScholarPubMed
Chatterjee, A., Anderson, K.E., Moskowitz, C.B., Hauser, W.A., Marder, K.S. (2005). A comparison of self-report and caregiver assessment of depression, apathy, and irritability in Huntington's Disease. Journal of Neuropsychiatry and Clinical Neurosciences, 17(3), 378–383.CrossRefGoogle ScholarPubMed
Chiaravalloti, N.D., DeLuca, J. (2003). Assessing the behavioral consequences of multiple sclerosis: An application of the Frontal Systems Behavior Scale (FrSBe). Cognitive and Behavioral Neurology, 16(1), 54–67.CrossRefGoogle ScholarPubMed
Davis, J.D., Tremont, G. (2007). Impact of frontal systems behavioral functioning in dementia on caregiver burden. Journal of Neuropsychiatry and Clinical Neurosciences, 19(1), 43–49.CrossRefGoogle ScholarPubMed
Delis, D.C., Kaplan, E., Kramer, J.H. (2001). Delis-Kaplan Executive Function System: Examiner's manual. San Antonio, TX: The Psychological Corporation.Google Scholar
Denheyer, M., Kiss, Z.H., Haffenden, A.M. (2009). Behavioral effects of subthalamic deep brain stimulation in Parkinson's disease. Neuropsychologia, 47(14), 3203–3209.CrossRefGoogle ScholarPubMed
Emre, M., Aarsland, D., Brown, R., Burn, D.J., Duyckaerts, C., Mizuno, Y., Dubois, B. (2007). Clinical diagnostic criteria for dementia associated with Parkinson's disease. Movement Disorders, 22(12), 1689–1707.CrossRefGoogle ScholarPubMed
Ertan, F.S., Ertan, T., Kiziltan, G., Uygucgil, H. (2005). Reliability and validity of the Geriatric Depression Scale in depression in Parkinson's disease. Journal of Neurology, Neurosurgery, & Psychiatry, 76(10), 1445–1447.CrossRefGoogle ScholarPubMed
Fahn, S., Elton, R.L., the UPDRS Development Committee (1987). Unified Parkinson's Disease Rating Scale. In S. Fahn, C.D. Marsden, D. Calne, & M. Goldstein, (Eds.),, Recent developments in Parkinson's disease, (pp. 153–163, Vol. 2). Florham Park, NJ: Macmillan Healthcare Information.Google Scholar
Fleiss, J.L. (1981). Statistical methods for rates and proportions. New York, NY: John Wiley.Google Scholar
Gibb, W.R., Lees, A.J. (1989). The significance of the Lewy body in the diagnosis of idiopathic Parkinson's disease. Neuropathology and Applied Neurobiology, 15(1), 27–44.CrossRefGoogle ScholarPubMed
Goetz, C.G., Poewe, W., Rascol, O., Sampaio, C., Stebbins, G.T., Counsell, C., Seidl, L. (2004). Movement Disorder Society Task Force Report on the Hoehn and Yahr Staging Scale: Status and recommendations. Movement Disorders, 19(9), 1020–1028.CrossRefGoogle ScholarPubMed
Goetz, C.G., Stebbins, G.T., Tilley, B.C. (2012). Calibration of Unified Parkinson's Disease Rating Scale Scores to Movement Disorder Society-Unified Parkinson's Disease Rating Scale Scores. Movement Disorders, 27(10), 1239–1242.CrossRefGoogle ScholarPubMed
Goetz, C.G., Tilley, B.C., Shaftman, S.R., Stebbins, G.T., Fahn, S., Martinez-Martin, P., … Movement Disorder Society UPDRS Revision Task Force. (2008). Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Scale presentation and clinimetric testing results. Movement Disorders, 23, 2129–2170.CrossRefGoogle ScholarPubMed
Gotham, A.M., Brown, R.G., Marsden, C.D. (1988). ‘Frontal’ cognitive function in patients with Parkinson's disease ‘on’ and ‘off’ levodopa. Brain, 111(Pt 2), 299–321.CrossRefGoogle ScholarPubMed
Grace, J., Malloy, P. (2001). Frontal Systems Behavior Scale: Professional manual. Lutz, FL: Psychological Assessment Resources, Inc.Google Scholar
Grace, J., Stout, J.C., Malloy, P.F. (1999). Assessing frontal lobe behavioral syndromes with the frontal lobe personality scale. Assessment, 6(3), 269–284.CrossRefGoogle ScholarPubMed
Heaton, R.K., Chelune, G.J., Talley, J.L., Kay, G.G., Curtiss, G. (1993). Wisconsin Card Sorting Test manual: Revised and expanded. Odessa, FL: Psychological Assessment Resources.Google Scholar
Hoehn, M.M., Yahr, M.D. (1967). Parkinsonism: Onset, progression and mortality. Neurology, 17(5), 427–442.CrossRefGoogle ScholarPubMed
Huprich, S.K., Bornstein, R.F., Schmitt, T.A. (2011). Self-report methodology is insufficient for improving the assessment and classification of Axis II personality disorders. Journal of Personality Disorders, 25(5), 557–570.CrossRefGoogle ScholarPubMed
Kulisevsky, J., Avila, A., Barbanoj, M., Antonijoan, R., Berthier, M.L., Gironell, A. (1996). Acute effects of levodopa on neuropsychological performance in stable and fluctuating Parkinson's disease patients at different levodopa plasma levels. Brain, 119(Pt 6), 2121–2132.CrossRefGoogle ScholarPubMed
Leritz, E., Loftis, C., Crucian, G., Friedman, W., Bowers, D. (2004). Self-awareness of deficits in Parkinson disease. The Clinical Neuropsychologist, 18(3), 352–361.CrossRefGoogle ScholarPubMed
Marsh, L., McDonald, W.M., Cummings, J., Ravina, B. (2006). Provisional diagnostic criteria for depression in Parkinson's disease: Report of an NINDS/NIMH Work Group. Movement Disorders, 21(2), 148–158.CrossRefGoogle ScholarPubMed
Mathias, J.L. (2003). Neurobehavioral functioning of persons with Parkinson's disease. Applied Neuropsychology, 10(2), 57–68.CrossRefGoogle ScholarPubMed
Mattis, S. (1988). Dementia Rating Scale. Odessa, FL: Psychological Assessment Resources.Google Scholar
McKinlay, A., Grace, R.C., Dalrymple-Alford, J.C., Anderson, T.J., Fink, J., Roger, D. (2008). Neuropsychiatric problems in Parkinson's disease: Comparisons between self and caregiver report. Aging & Mental Health, 12(5), 647–653.CrossRefGoogle ScholarPubMed
Shoukri, M.M. (2004). Measures of Interobserver Agreement. Boca Raton: Chapman & Hall/CRC.Google Scholar
Sitek, E.J., Soltan, W., Wieczorek, D., Robowski, P., Slawek, J. (2011). Self-awareness of memory function in Parkinson's disease in relation to mood and symptom severity. Aging & Mental Health, 15(2), 150–156.CrossRefGoogle ScholarPubMed
Starkstein, S.E., Brockman, S. (2011). Apathy and Parkinson's disease. Current Treatment Options in Neurology, 13(3), 267–273.CrossRefGoogle ScholarPubMed
Stout, J.C., Ready, R.E., Grace, J., Malloy, P.F., Paulsen, J.S. (2003). Factor analysis of the frontal systems behavior scale (FrSBe). Assessment, 10(1), 79–85.CrossRefGoogle ScholarPubMed
Tomlinson, C.L., Stowe, R., Patel, S., Rick, C., Gray, R., Clarke, C.E. (2010). Systematic review of levodopa dose equivalency reporting in Parkinson's disease. Movement Disorders, 25(15), 2649–2653.CrossRefGoogle ScholarPubMed
Yesavage, J.A., Brink, T.L., Rose, T.L., Lum, O., Huang, V., Adey, M., Leirer, V.O. (1982). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17(1), 37–49.CrossRefGoogle Scholar
Zarit, S.H., Reever, K.E., Bach-Peterson, J. (1980). Relatives of the impaired elderly: Correlates of feelings of burden. Gerontologist, 20(6), 649–655.CrossRefGoogle ScholarPubMed
Zgaljardic, D.J., Borod, J.C., Foldi, N.S., Mattis, P. (2003). A review of the cognitive and behavioral sequelae of Parkinson's disease: Relationship to frontostriatal circuitry. Cognitive and Behavioral Neurology, 16(4), 193–210.CrossRefGoogle ScholarPubMed
Zgaljardic, D.J., Borod, J.C., Foldi, N.S., Rocco, M., Mattis, P.J., Gordon, M.F., Eidelberg, D. (2007). Relationship between self-reported apathy and executive dysfunction in nondemented patients with Parkinson disease. Cognitive and Behavioral Neurology, 20(3), 184–192.CrossRefGoogle ScholarPubMed