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Scale for the Assessment of Positive Symptoms-Parkinson’s Disease (SAPS-PD)
Availability
Please visit this website for more information about the instrument: Scale for the Assessment of Positive Symptoms.
Classification
Supplemental – Highly Recommended: Parkinson’s Disease (PD)
Short Description of Instrument
The Scale for the Assessment of Positive Symptoms (SAPS) was originally designed to assess positive symptoms of psychopathology principally that occur in schizophrenia (Andreasen, 1984). These symptoms include hallucinations, delusions, bizarre behavior, and positive formal thought disorder. Although originally designed for use in schizophrenia, the SAPS have been found to be reliable in Parkinson’s Disease populations and are a recommended scale for use in Parkinson’s Disease Psychosis (PDP) (Fernandez et al., 2008). The SAPS- PD is a shortened version of the original SAPS scale which includes a subset of questions from the hallucinations and delusions subdomains (SAPS-H+D) indicative of those symptoms most commonly seen in a PDP patient population (Voss et al., 2013).
Comments/Special Instructions
The SAPS is a structured clinical interview that covers 35 items in the domains of: hallucinations (7 items), delusions (13 items), bizarre behavior (5 items), positive formal thought disorder (9-items), and inappropriate affect (1-item). The SAPS-PD is a shortened version of the SAPS that consists of 9-items from the H+D subdomains (Auditory hallucinations, Voices conversing, Somatic or tactile hallucinations, Visual hallucinations, Global rating of severity of hallucinations, Persecutory delusions, Delusions of jealousy, Delusions of reference, and Global rating of severity of delusions) (Voss et al., 2013).
Scoring
Each item is scored on a scale of 0–5: 0 = None/None at all
1 = Questionable
2 = Mild
3 = Moderate
4 = Marked
5 = Severe
The sum of the 9 items (4 hallucination plus 1 global hallucination items; 3 delusion plus 1 global hallucination items) produces a total score of 0-45.
Rationale/Justification
The SAPS-PD is a reliable scale which can effectively be utilized for clinical trials in PDP as it measures the symptoms most relevant in a patient with PDP: hallucinations and delusions. Although the full 34 item SAPS has been found to be reliable in Parkinson’s Disease Psychosis (PDP) (Voss et al., 2010), it includes numerous items that are not relevant to the PDP population, such as bizarre behavior or positive formal thought disorder. The scale does not specifically assess presence and passage hallucinations and visual illusions; however, these are likely assessed as part of the global assessment of hallucinations.
 
In a retrospective analysis of three large clinical trials in a PDP population which utilized the SAPS-H+D subdomains, only 5 hallucination items and 4 delusion items occurred at a frequency greater than 10%. Only these 9 items are included in the shortened SAPS-PD scale (Voss et al., 2013).
Recommended Instrument for
PD
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