Assessment of Affective-Behavioral States in Parkinson's Disease Patients: Toward a New Screening Tool.

Schedlich-Teufer, Charlotte; Jost, Stefanie Theresa; Krack, Paul; Witt, Karsten; Weintraub, Daniel; Baldermann, Juan Carlos; Sommerauer, Michael; Amstutz, Deborah; van Eimeren, Thilo; Dafsari, Haidar Salimi; Kalbe, Elke; Visser-Vandewalle, Veerle; Fink, Gereon Rudolf; Kessler, Josef; Barbe, Michael Thomas (2021). Assessment of Affective-Behavioral States in Parkinson's Disease Patients: Toward a New Screening Tool. Journal of Parkinson's disease, 11(3), pp. 1417-1430. IOS Press 10.3233/JPD-202375

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Assessment of affective-behavioral states in patients with Parkinson's disease (PD) undergoing deep brain stimulation (DBS) is essential.


To analyze well-established questionnaires as a pilot-study with the long term aim to develop a screening tool evaluating affective-behavioral dysfunction, including depression, anxiety, apathy, mania, and impulse control disorders, in PD patients screened for DBS.


Two hundred ninety-seven inpatients with PD underwent standardized neuropsychiatric testing including German versions of Beck Depression Inventory-II, Hospital Anxiety and Depression Scale, Apathy Evaluation Scale, Self-Report Manic Inventory, and Questionnaire for Impulsive-Compulsive Disorders in PD-Rating Scale, to assess appropriateness for DBS. Statistical item reduction was based on exploratory factor analysis, Cronbach's alpha, item-total correlations, item difficulty, and inter-item correlations. Confirmatory factor analysis was conducted to assess factorial validity. An expert rating was performed to identify clinically relevant items in the context of PD and DBS, to maintain content validity. We compared the shortened subscales with the original questionnaires using correlations. To determine cutoff points, receiver operating characteristics analysis was performed.


The items of the initial questionnaires were reduced from 129 to 38 items. Results of confirmatory factor analyses supported the validity of the shortened pool. It demonstrated high internal consistency (Cronbach's alpha = 0.72-0.83 across subscales), and the individual subscales were correlated with the corresponding original scales (rs = 0.84-0.95). Sensitivities and specificities exceeded 0.7.


The shortened item pool, including 38 items, provides a good basis for the development of a screening tool, capturing affective-behavioral symptoms in PD patients before DBS implantation. Confirmation of the validity of such a screening tool in an independent sample of PD patients is warranted.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Krack, Paul, Amstutz, Deborah


600 Technology > 610 Medicine & health




IOS Press




Chantal Kottler

Date Deposited:

13 Jul 2021 14:38

Last Modified:

05 Dec 2022 15:52

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Parkinson’s disease anxiety apathy deep brain stimulation depression hallucinations impulse control disorders mania questionnaire screening tool


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