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Questionnaire Impulsive-Compulsive Disorders Parkinson's Disease-Rating Scale (QUIP-RS)
Please email the author for information about obtaining the instrument: Dr. Daniel Weintraub,
Permission for use should be sought from the author, Dr. Weintraub. The University of Pennsylvania holds the copyright to the QUIP and QUIP-RS. The QUIP-RS can be used free of charge for clinical or personal academic use.
Supplemental - Highly Recommended: Parkinson's Disease (PD)
Recommendations for use: Indicated for studies assessing impulse control and behavioral disturbances in PD as primary or secondary outcome and when assessment of change over time or before and after intervention is required.
Short Description of Instrument
The Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS) is a 28-item patient reported or clinician rated scale that quantifies the severity of a variety of compulsive disorders and behaviors reported to occur in Parkinson's disease (PD); supports a diagnosis of impulse control disorders or behaviors (ICDs); and monitors changes in patient's ICD symptom severity with time, including response to treatment.
Comments/Special Instructions
The QUIP-RS has been professionally translated from English into 17 languages for use in 23 countries or regions. It has been separately validated in German (Probst et al., 2014). Subsequent to its initial validation, the QUIP-RS was shown to be sensitive to treatment effects in a randomized, double-blind, placebo-controlled clinical trial for ICDs in PD (Weintraub et al., 2015).
Scoring and Psychometric Properties
Scoring: The QUIP-RS has 4 primary questions (pertaining to commonly reported thoughts, urges/desires, and behaviors associated with ICDs), each applied to the 4 ICDs (compulsive gambling, buying, eating, and sexual behavior) and 3 related disorders (medication use, punding, and hobbyism). It uses a 5-point Likert scale (score 0-4 for each question) to gauge the frequency of behaviors and instructs patients to answer questions based on behaviors that occurred in the preceding 4 weeks (or any 4-week period in a designated time frame). The QUIP-RS is administered with an instruction sheet that provides examples of the behaviors being assessed and a brief description of the Likert scale categories for frequency (i.e., never [0] = not at all, rarely [1] = infrequently or 1 day/week, etc.). Scores for each ICD and related disorder range from 0 to 16, with a higher score indicating greater severity (i.e., frequency) of symptoms. Due to overlap, hobbyism and punding were combined in the validation process to form a single diagnosis (hobbyism-punding), with a total score ranging from 0 to 32 for the combined disorder. The total QUIP-RS score for all ICDs and related disorders combined ranges from 0 to 112.
Psychometric Properties: A convenience sample of PD patients at a movement disorders clinic self-completed the QUIP-RS and were administered a semi-structured diagnostic interview by a blinded trained rater to assess discriminant validity for impulse control disorders (n = 104) and related disorders (n = 77). Subsets of patients were assessed to determine interrater reliability (n = 104), retest reliability (n = 63), and responsiveness to change (n = 29). Adequate cutoff points (both sensitivity and specificity values >80% plus acceptable likelihood ratios) were established for each impulse control disorder and hobbyism-punding. Interrater and retest reliability (intraclass correlation coefficient r) were >0.60 for all disorders (Weintraub et al., 2012).
Impulse control disorders (ICDs) and related behaviors (punding, hobbyism and dopamine dysregulation syndrome) constitute a group of psychiatric disorders that include pathological gambling and compulsive sexual behavior, and buying, and eating. These disorders occur at a baseline rate of 1-8% in the general population but occur at a significantly higher rate in individuals with Parkinson's disease. They are also a potential side-effect of several classes of medication, particularly those targeting the dopamine system (i.e., dopamine agonists, levodopa, and amantadine). Therefore, tools are needed to establish the existence or development of ICDs in at risk individuals, and to monitor changes in the severity of these behaviors.
Strengths: This scale is valid and reliable for rating the severity of ICDs.
Weaknesses: This scale is not validated for dopamine dysregulation syndrome; cutoff points for ICDs were established in a North American sample and may not be generalizable to other populations.
Key Reference:
Weintraub D, Mamikonyan E, Papay K, Shea JA, Xie SX, Siderowf A. Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale. Mov Disord. 2012 Feb;27(2):242-7.
Additional References:
Probst CC, Winter LM, MÖller B, Weber H, Weintraub D, Witt K, Deuschl G, Katzenschlager R, van Eimeren T. Validation of the questionnaire for impulsive-compulsive disorders in Parkinson's disease (QUIP) and the QUIP-rating scale in a German speaking sample. J Neurol. 2014 May;261(5):936-42. Erratum in: J Neurol. 2015 Sep;262(9):2200.
Weintraub D, Papay K, Xie SX. Naltrexone for impulse control disorders in Parkinson disease: a placebo-controlled study. Neurology. 2015 Mar 31;84(13):1386-7.
Document last updated August 2022