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. 2024 Jun 13:3:1377191.
doi: 10.3389/frdem.2024.1377191. eCollection 2024.

Psychosis detection in dementia: a systematic review of diagnostic test accuracy studies

Kayla Atchison  1 , Pauline Wu  1 , Jennifer A Watt  2 , Dallas Seitz  3   4 , Zahinoor Ismail  3   4 , Zahra Goodarzi  1   4   5
Affiliations

Psychosis detection in dementia: a systematic review of diagnostic test accuracy studies

Kayla Atchison et al. Front Dement. .

Abstract

Introduction: Symptoms of psychosis, characterized by delusions and hallucinations, are commonly experienced by persons living with dementia. A systematic review was completed to identify tools to evaluate symptoms of psychosis compared to a reference standard in persons with dementia. Articles reporting correlation values between psychosis tools were also identified.

Methods: The search concepts psychosis, dementia, and diagnostic accuracy were used to search MEDLINE, PsycINFO, and Embase. Included articles meeting the primary objective described a tool to assess symptoms of psychosis, delusions, or hallucinations in persons with dementia, a reference standard form of diagnostic assessment for psychosis, and diagnostic accuracy outcomes for the psychosis tool. Secondary objective articles reported correlation values between two or more psychosis tools in persons with dementia.

Results: One study met the primary objective and described the sensitivity and specificity of the Neuropsychiatric Inventory (NPI) and Columbia University Scale for Psychopathology in Alzheimer's Disease (CUSPAD) in identifying symptoms of psychosis, hallucinations, and delusions. The sensitivity of the NPI and CUSPAD in identifying symptoms of psychosis was 83 and 90%, respectively. Nine studies meeting the secondary objective described eleven unique tools and examined the degree to which tools used to assess psychotic symptoms in persons with dementia were related.

Discussion: The NPI and CUSPAD were identified in a single study as psychosis tools that have been evaluated against a reference standard of psychosis assessment in persons with dementia. Various tools to assess the burden of psychotic symptoms in persons with dementia exist, but the diagnostic accuracy of existing tools remains understudied. Further research on the comparative utility and diagnostic accuracy is required for all psychosis tools used with persons with dementia.

Keywords: delusions; dementia; detection; hallucinations; psychosis; sensitivity; systematic review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
PRISMA flow diagram of study inclusion in systematic review (Page et al., 2021). Ten studies excluded based on Reference test not gold standard or No diagnostic accuracy outcomes are reported on in the present systematic review based on the correlation values or rates of clinical improvement they report between psychosis index tools.
See this image and copyright information in PMC

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