The Neuropsychiatric Inventory

Article abstract-The Neuropsychiatric Inventory (NPI) was developed to assess psychopathology in dementia patients. It evaluates 12 neuropsychiatric disturbances common in dementia: delusions, hallucinations, agitation, dysphoria, anxiety, apathy, irritability, euphoria, disinhibition, aberrant motor behavior, night-time behavior disturbances, and appetite and eating abnormalities. The severity and frequency of each neuropsychiatric symptom are rated on the basis of scripted questions administered to the patient's caregiver. The NPI also assesses the amount of caregiver distress engendered by each of the neuropsychiatric disorders. A total NPI score and a total caregiver distress score are calculated, in addition to the scores for the individual symptom domains. Content validity, concurrent validity, inter-rater reliability, and test-retest reliability of the NPI are established. Different neurologic disorders have characteristic neuropsychiatric manifestations and distinctive NPI profiles. The NPI is sensitive to treatment effects and has demonstrated the amelioration of behavioral symptoms in Alzheimer's disease by cholinergic agents. The NPI is a useful instrument for characterizing the psychopathology of dementia syndromes, investigating the neurobiology of brain disorders with neuropsychiatric manifestations, distinguishing among different dementia syndromes, and assessing the efficacy of treatment. NEUROLOGY 1997;48(Suppl 6): S10-S16

[1]  Bruce L. Miller,et al.  Frontal lobe degeneration: clinical, neuropsychological and SPECT characteristics , 1998 .

[2]  J. Cummings,et al.  Neuropsychiatric aspects of Alzheimer's disease , 1996, Neurology.

[3]  M. Hallett,et al.  Clinical research criteria for the diagnosis of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome) , 1996, Neurology.

[4]  B L Miller,et al.  Alzheimer disease and frontotemporal dementias. Behavioral distinctions. , 1996, Archives of neurology.

[5]  H. Chui,et al.  Physical aggression is associated with preservation of substantia nigra pars compacta in Alzheimer disease. , 1996, Archives of neurology.

[6]  J. Cummings,et al.  Effect of Tacrine on Behavioral Symptoms in Alzheimer's Disease: An Open-Label Study , 1996, Journal of geriatric psychiatry and neurology.

[7]  Jeffrey L. Cummings,et al.  The spectrum of behavioral changes in Alzheimer's disease , 1996, Neurology.

[8]  R. Daroff A new look and feel , 1996, Neurology.

[9]  B. Lawlor,et al.  Biologic Markers and Neurochemical Correlates of Agitation and Psychosis in Dementia , 1995, Journal of geriatric psychiatry and neurology.

[10]  Gene E. Alexander,et al.  Abnormal brain glucose metabolism in the delusional misidentification syndromes: A positron emission tomography study in Alzheimer disease , 1995, Biological Psychiatry.

[11]  M. Casanova,et al.  Decreased DOPAC in the anterior cingulate cortex of individuals with schizophrenia , 1995, Biological Psychiatry.

[12]  M. Albert,et al.  Utility of extrapyramidal signs and psychosis as predictors of cognitive and functional decline, nursing home admission, and death in Alzheimer's disease , 1994, Neurology.

[13]  M. Mega,et al.  The Neuropsychiatric Inventory , 1994, Neurology.

[14]  R. Leiguarda,et al.  A SPECT study of delusions in Alzheimer's disease , 1994, Neurology.

[15]  L. Schneider,et al.  Extrapyramidal signs and psychiatric symptoms predict faster cognitive decline in Alzheimer's disease. , 1994, Archives of neurology.

[16]  Clinical and neuropathological criteria for frontotemporal dementia. The Lund and Manchester Groups. , 1994, Journal of neurology, neurosurgery, and psychiatry.

[17]  E. Peskind,et al.  Neurobiologic Bases of Noncognitive Behavioral Problems in Alzheimer Disease , 1994, Alzheimer disease and associated disorders.

[18]  M. Albert,et al.  Delusions and patterns of cognitive impairment in Alzheimer's disease , 1994 .

[19]  B. L. Beattie,et al.  Neuropsychological Deficits, Caregivers' Perception of Deficits and Caregiver Burden , 1994, Journal of the American Geriatrics Society.

[20]  J. Goodwin,et al.  Aggressive Behaviors among the Institutionalized Elderly , 1993, Journal of the American Geriatrics Society.

[21]  M. Aronson,et al.  Dementia, Agitation, and Care in the Nursing Home , 1993, Journal of the American Geriatrics Society.

[22]  J. Rabe-Jabłońska,et al.  [Affective disorders in the fourth edition of the classification of mental disorders prepared by the American Psychiatric Association -- diagnostic and statistical manual of mental disorders]. , 1993, Psychiatria polska.

[23]  W. Reichman,et al.  The relationship between dementia and elder abuse. , 1993, The American journal of psychiatry.

[24]  R. Hales,et al.  J Neuropsychiatry Clin Neurosci , 1992 .

[25]  M. Finch,et al.  Predictors of cognitive and functional progression in patients with probable Alzheimer's disease , 1992, Neurology.

[26]  M. Folstein,et al.  Psychiatric Diagnosis and Uncooperative Behavior in Nursing Homes , 1992, Journal of geriatric psychiatry and neurology.

[27]  D. Jeste,et al.  Cognitive deficits of patients with Alzheimer's disease with and without delusions. , 1992, The American journal of psychiatry.

[28]  B. O’Donnell,et al.  Incontinence and Troublesome Behaviors Predict Institutionalization in Dementia , 1992, Journal of geriatric psychiatry and neurology.

[29]  Lippincott Williams Wilkins,et al.  Assessment: Magnetoencephalography (MEG) , 1992 .

[30]  M. Folstein,et al.  Psychosis and physical aggression in probable Alzheimer's disease. , 1991, The American journal of psychiatry.

[31]  B. L. Miller,et al.  Frontal lobe degeneration , 1991, Neurology.

[32]  J. Moossy,et al.  Neuropathologic and neurochemical correlates of psychosis in primary dementia. , 1991, Archives of neurology.

[33]  J. Becker,et al.  Alzheimer's disease with delusions and hallucinations , 1991, Neurology.

[34]  J. Kurtzke,et al.  On the production of neurologists in the United States , 1991, Neurology.

[35]  G A Chase,et al.  Psychiatric symptoms and nursing home placement of patients with Alzheimer's disease. , 1990, The American journal of psychiatry.

[36]  J. Moossy,et al.  Neurochemical correlates of major depression in primary dementia. , 1990, Archives of neurology.

[37]  J. Cummings,et al.  Personality Alterations in Dementia of the Alzheimer Type: A Three-Year Follow-up Study , 1989, Journal of geriatric psychiatry and neurology.

[38]  R. Pruchno,et al.  Aberrant behaviors and Alzheimer's disease: mental health effects on spouse caregivers. , 1989, Journal of gerontology.

[39]  M. A. Stephens,et al.  Caregiving Hassles Scale: assessing the daily hassles of caring for a family member with dementia. , 1989, The Gerontologist.

[40]  D. Jeste,et al.  Overview of depression and psychosis in Alzheimer's disease. , 1989, The American journal of psychiatry.

[41]  R. Pruchno,et al.  Husbands and wives as caregivers: antecedents of depression and burden. , 1989, The Gerontologist.

[42]  M. Jenike Letter to Readers , 1989 .

[43]  J. Cummings,et al.  Personality alterations in dementia of the Alzheimer type. , 1988, Archives of neurology.

[44]  L. Wolfson,et al.  Visual hallucinations as the first symptom of Alzheimer's disease. , 1988, The American journal of psychiatry.

[45]  D. Price,et al.  The neuropathology of aminergic nuclei in Alzheimer's disease , 1988, Progress in clinical and biological research.

[46]  M. Ryden AGGRESSIVE BEHAVIOR IN PERSONS WITH DEMENTIA WHO LIVE IN THE COMMUNITY , 1988, Alzheimer disease and associated disorders.

[47]  S H Ferris,et al.  Behavioral symptoms in Alzheimer's disease: phenomenology and treatment. , 1987, The Journal of clinical psychiatry.

[48]  P V Rabins,et al.  The impact of dementia on the family. , 1982, JAMA.

[49]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[50]  M. Hamilton,et al.  Development of a rating scale for primary depressive illness. , 1967, The British journal of social and clinical psychology.

[51]  J. Cummings,et al.  Depressive Symptoms in Alzheimer Disease: Assessment and Determinants , 1995, Alzheimer disease and associated disorders.

[52]  J. Cummings,et al.  Psychometric and SPECT studies in alzheimer’s disease with and without delusions , 1995 .

[53]  I. Martinson,et al.  The frequency and troublesomeness of symptoms associated with Alzheimer's disease. , 1995, Journal of community health nursing.

[54]  M. Viederman Grief: normal and pathological variants. , 1995, The American journal of psychiatry.

[55]  J. Cummings,et al.  Repetitive and compulsive behavior in frontal lobe degenerations. , 1994, The Journal of neuropsychiatry and clinical neurosciences.

[56]  G. Zubenko Biological correlates of clinical heterogeneity in primary dementia. , 1992, Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology.

[57]  J. Cummings,et al.  Delusions in dementia syndromes: investigation of behavioral and neuropsychological correlates. , 1991, The Journal of neuropsychiatry and clinical neurosciences.

[58]  M. Folstein,et al.  Delusions in newly admitted residents of nursing homes. , 1990, The American journal of psychiatry.

[59]  P J Whitehouse,et al.  Psychiatric symptoms associated with Alzheimer's disease. , 1990, The Journal of neuropsychiatry and clinical neurosciences.

[60]  J V Haxby,et al.  Subgroups in dementia of the Alzheimer type identified using positron emission tomography. , 1990, The Journal of neuropsychiatry and clinical neurosciences.

[61]  J. Cummings,et al.  Noncognitive neuropsychiatric syndromes in alzheimer’s disease , 1990 .

[62]  E. Rubin,et al.  Psychopathology of very mild dementia of the Alzheimer type. , 1989, The American journal of psychiatry.

[63]  M. Sabshin A Milestone in the History of the Journal , 1989 .

[64]  J. Bowlby,et al.  Developmental psychiatry comes of age. , 1988, The American journal of psychiatry.

[65]  M. Folstein,et al.  Prevalence of mental illness in a community nursing home. , 1986, The American journal of psychiatry.

[66]  Donovan Jm An etiologic model of alcoholism. , 1986 .