Objective: This study aimed to develop an item bank for assessing psychosis in Parkinson’s disease (PD).

Background: Psychosis is a common and debilitating symptom in PD, affecting approximately 50% of patients at some point in their disease ^[1]. However, the complex and fluctuating nature of psychosis presents assessment challenges for accurate characterization. To address this issue, we developed an item bank by collecting individual items from various Clinical Outcome Assessments (COA) currently used to assess PD psychosis (PDP) and categorized them into relevant symptom categories.

Method: We conducted a systematic review in accordance with the Joanna Briggs Institute (JBI) methodology ^[2]. We performed a comprehensive search with no limitation regarding time on four electronic databases, MEDLINE, EMBASE, PsycINFO, and Scopus, and additional hand-searching. We used keywords related to PD, psychosis, and assessment. We identified and selected items from existing COA, including Patient-Reported Outcome (PRO), Clinician-Reported Outcome (ClinRO), or Observer-Reported Outcome (ObsRO) measures. We curated the items according to the categories of symptoms and effects of PDP.

Results: We screened 5,673 studies and included 629 in our analysis. We identified 36 COA currently used to assess PDP [Figure 1], 22 were PD-specific and composed of 545 items, and 14 were Non-PD-Specific and composed of 297 items, totaling 842 items [Table 1]. Of these, 14 were PRO with 267 items which 137 assess PDP, 18 were ClinRO measures and composed of 271 total items, of which 170 assess PDP, and 4 were ObsRO with 7 items, of which 6 assess PDP [Table 1]. We classified the items into eight thematic categories including experiences of hallucinations, delusions, and illusions, the impact of psychosis, false sense of presence and passage, medication effects, and clinical global impression. The categories were then classified into 36 subcategories [Table 2].

Conclusion: Our study provides an important first step for charting prioritized items for the assessment of PDP. The item bank allows the identification of a variety of COA and items used to measure this construct and highlights the symptom categories and subcategories of most commonly deemed interest. As the MDS moves into the development of a PD-Psychosis scale, these data will help guide decisions on priorities and completeness, applicable to clinical care and research trials.

References: Acknowledgments: Dag Aarsland; Shazia Ali; Jennifer G Goldman; Tien K Khoo; Simon JG Lewis; Pablo Martinez-Martin; Oluwadamilola O Ojo; Javier Pagonabarraga; Anette Schrag; Sandra Videmsky; Daniel Weintraub.

[1] Aarsland D, Marsh L, and Schrag A. Neuropsychiatric symptoms in Parkinson’s disease. Mov Disord. 2009;24(15):2175-86.
[2] Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis, JBI, 2020. Available from https://synthesismanual.jbi.global. https://doi.org/10.46658/JBIMES-20-12.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/development-of-an-item-bank-for-assessing-psychosis-in-parkinsons-disease-a-systematic-review/