The Extrapyramidal Symptom Rating Scale and Its Abbreviated Version: A Critical Review of Clinimetric Properties.

Antipsychotics Drug-induced movement disorders Dyskinesia Extrapyramidal symptoms Parkinsonism

Journal

Psychotherapy and psychosomatics
ISSN: 1423-0348
Titre abrégé: Psychother Psychosom
Pays: Switzerland
ID NLM: 0024046

Informations de publication

Date de publication:
07 Dec 2023
Historique:
received: 17 09 2023
accepted: 07 11 2023
medline: 8 12 2023
pubmed: 8 12 2023
entrez: 7 12 2023
Statut: aheadofprint

Résumé

The Extrapyramidal Symptom Rating Scale - Abbreviated (ESRS-A) is an abbreviated version of the Extrapyramidal Symptom Rating Scale (ESRS) with instructions, definitions, and a semi-structured interview that follows clinimetric concepts of measuring clinical symptoms. Similar to the ESRS, the ESRS-A was developed to assess four types of drug-induced movement disorders (DIMD): parkinsonism, akathisia, dystonia, and tardive dyskinesia (TD). The present review of the literature provides the most relevant clinimetric properties displayed by the ESRS and ESRS-A in clinical studies. Comprehensive ESRS-A definitions, official scale, and basic instructions are provided. ESRS inter-rater reliability was evaluated in two pivotal studies and in multicenter international studies. Inter-rater reliability was high for assessing both antipsychotic-induced movement disorders and idiopathic Parkinson's disease. Guidelines were also established for inter-rater reliability and the rater certification processes. The ESRS showed good concurrent validity with 96% agreement between Abnormal Involuntary Movement Scale (AIMS) for TD-defined cases and ESRS-defined cases. Similarly, concurrent validity for ESRS-A total and subscores for parkinsonism, akathisia, dystonia, and dyskinesia ranged from good to very good. The ESRS was particularly sensitive for detecting DIMD-related movement differences following treatment with placebo, antipsychotics, and antiparkinsonian and antidyskinetic medications. ESRS measurement of drug-induced extrapyramidal symptoms was shown to discriminate extrapyramidal symptoms from psychiatric symptoms. The ESRS and ESRS-A are valid clinimetric indices for measuring DIMD. They can be valuably implemented in clinical research, particularly in trials testing antipsychotic medications, and in clinics to detect the presence, severity, and response to treatment of movement disorders.

Sections du résumé

BACKGROUND BACKGROUND
The Extrapyramidal Symptom Rating Scale - Abbreviated (ESRS-A) is an abbreviated version of the Extrapyramidal Symptom Rating Scale (ESRS) with instructions, definitions, and a semi-structured interview that follows clinimetric concepts of measuring clinical symptoms. Similar to the ESRS, the ESRS-A was developed to assess four types of drug-induced movement disorders (DIMD): parkinsonism, akathisia, dystonia, and tardive dyskinesia (TD).
SUMMARY CONCLUSIONS
The present review of the literature provides the most relevant clinimetric properties displayed by the ESRS and ESRS-A in clinical studies. Comprehensive ESRS-A definitions, official scale, and basic instructions are provided. ESRS inter-rater reliability was evaluated in two pivotal studies and in multicenter international studies. Inter-rater reliability was high for assessing both antipsychotic-induced movement disorders and idiopathic Parkinson's disease. Guidelines were also established for inter-rater reliability and the rater certification processes. The ESRS showed good concurrent validity with 96% agreement between Abnormal Involuntary Movement Scale (AIMS) for TD-defined cases and ESRS-defined cases. Similarly, concurrent validity for ESRS-A total and subscores for parkinsonism, akathisia, dystonia, and dyskinesia ranged from good to very good. The ESRS was particularly sensitive for detecting DIMD-related movement differences following treatment with placebo, antipsychotics, and antiparkinsonian and antidyskinetic medications. ESRS measurement of drug-induced extrapyramidal symptoms was shown to discriminate extrapyramidal symptoms from psychiatric symptoms.
KEY MESSAGES CONCLUSIONS
The ESRS and ESRS-A are valid clinimetric indices for measuring DIMD. They can be valuably implemented in clinical research, particularly in trials testing antipsychotic medications, and in clinics to detect the presence, severity, and response to treatment of movement disorders.

Identifiants

DOI: 10.1159/000535113 PMID: 38061344
pubmed: 38061344
pii: 000535113
doi: 10.1159/000535113
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1-8

Informations de copyright

© 2023 S. Karger AG, Basel.

Auteurs

Guy Chouinard (G)

University Mental Health Institute of Montreal, University of Montreal, Montreal, Québec, Canada.
Clinical Pharmacology and Toxicology Program, Royal College of Physicians and Surgeons, McGill University, Montreal, Québec, Canada.

Fiammetta Cosci (F)

Department of Health Sciences, University of Florence, Florence, Italy.
International Lab of Clinical Measurements, University of Florence, Florence, Italy.

Virginie-Anne Chouinard (VA)

Psychotic Disorders Division, McLean Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Larry Alphs (L)

Larry Alphs Consulting, Princeton, New Jersey, USA.

Classifications MeSH