The Factor Structure of the Brief Psychiatric Rating Scale in Alzheimer's Disease

Abstract

The factor structure of the Brief Psychiatric Rating Scale (BPRS) is well established with young psychiatric patients. A study by Overall and Beller showed, however, that its factor structure was different with geropsychiatric patients. Although the BPRS has been used in assessing the behavioral characteristics of patients with probable Alzheimer's disease (AD), its factor structure has not been established with these patients. The present study investigated the factor structure of the BPRS among patients with clinically diagnosed AD by (NINCDS/ADRDA) criteria. The scale had limited usefulness with outpatients with mild AD. The factor structure obtained was similar to that found with other patient groups, but a unique factor, including the items Tension and Uncooperativeness, probably reflects the behavioral and psychological agitation characteristic of some AD patients. We recommend caution be taken in generalizing data from younger psychiatric samples to older adult patients with dementia.

References

1. Overall J , Gorham D. The Brief Psychiatric Rating Scale. Psychological Rep 1962; 10:799–812.

2. Hedlund JL , Vieweg BW . The Brief Psychiatric Rating Scale (BPRS): a comprehensive review. J Oper Psychiatry 1980; 11:48–65.

3. Overall J , Beller S. The brief Psychiatric Rating Scale in geropsychiatric research: I. Factor structure on an inpatient unit. J Gerontol 1984; 39:187–193.

4. Ownby RL , Seibel HP . Factor analyses of the Brief Psychiatric Rating Scale with older chronic inpatients: results of exploratory and confirmatory analyses. Multivariate Exp Clin Res 1994; 10:1–12.

5. Ownby RL , Seibel HP . Empirical clusters of disordered behavior among older psychiatric inpatients. J Gerontol Psychol Sci 1990; 45:P28–P32.

6. McKhann G , Drachman D , Folstein MF , et al. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA work group under the auspices of the Department of Health and Human Services Task Force on Alzheimer's disease. Neurology 1984; 34:939–944.

7. Folstein MF , Folstein S , McHugh PR . Mini Mental State: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12:189–198.

8. Morris JC , Mohs R , Rogers H , et al. CERAD clinical and neuropsychological assessment of Alzheimer's disease. Psychopharmacol Bull 1988; 24:641–651.

9. Morris J , Heyman A , Mohs R , et al. The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Neurology 1989; 39:1159–1165.

10.

10. Blessed G , Tomlinson B , Roth M. The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. Br J Psychiatry 1968; 114:797–811.

11.

11. Katzman R , Brown T , Fuld P , et al. Validation of a short orientation-memory concentration test of cognitive impairment. Am J Psychiatry 1983; 140:734–739.

12.

12. Hughes CP , Berg L , Danziger W , et al. A new clinical scale for the staging of dementia. Br J Psychiatry 1982; 140:566–572.

13.

13. Berg L. Clinical Dementia Rating (CDR). Psychopharmacol Bull 1988; 24(4):637–639.

14.

14. SPSS-PC Statistical Package for the Social Sciences (Version 4). New York: McGraw-Hill, 1988.

15.

15. Cattell R. The scree test for the number of factors. Multivariate Behav Res 1966; 1:245–276.

16.

16. Lerner AJ , Koss E , Patterson M , et al. Concomitants of visual hallucinations in Alzheimer's disease. Neurology 1994; 44:523–527.

17.

17. Alexopoulos GS , Abrams RC , Young RC , Shamoian CA . Cornell Scale for Depression in Dementia. Biol Psychiatry 1988; 23:271–284.

18.

18. Levin HS , High WM Jr , Goethe KE , et al. The Neurobehavioral Rating Scale: assessment of behavioral sequelae of head injury by the clinician. J Neurol Neurosurg Psychiatry 1986; 50:183–193.

19.

19. Patterson MB , Mack JL , et al. Behavioral disturbances in dementia: an evaluation of three rating scales. J Geriatr Psychiatry Neurol 1994; 7:101–117.

20.

20. Overall J , Klett C. Applied multivariate statistics. New York: McGraw Hill, 1972.