Validity and clinical utility of a Sinhalese version of the abnormal involuntary movement scale (AIMS)

Introduction

Tardive dyskinesia (TD) is a movement disorder caused by long-term treatment with dopamine antagonists such as antipsychotics. As there is no medication universally effective for TD, prevention is important. We propose that non-medical clinicians working in psychiatry can also be trained and involved in a screening programme for TD. To facilitate such a programme, validation of a standard tool translated to Sinhala is a need.

 

Aims

To translate and validate the Abnormal Involuntary Movement Scale (AIMS) into Sinhala.

 

Methods

Translation and pilot testing followed standard guidelines. The translated version was administered by five raters (two registrars in psychiatry, a medical officer, a community psychiatry nurse (CPN) and a psychiatric social worker) amongst patients treated with antipsychotic medication for a minimum of one year. The goldstandard diagnosis was the Diagnostic and Statistical Manual (DSM)-5 criteria, applied by a psychiatrist.

 

Results

Of the 137 patients screened (53.3% male; mean age = 49 years), the percentage of patients diagnosed with TD using AIMS and DSM-5 were 33% and 34%, respectively. The sensitivity and specificity of AIMS in detection of TD were 67% and 83.4% respectively. The degree of agreement between the AIMS and DSM- 5 indicated moderate criterion validity (Cohen's kappa= 0.5). For different raters, the agreement with the psychiatrist's diagnosis (kappa) ranged from 0.41 (CPN) to 0.63 (registrar), indicating modest reliability between raters.

 

Conclusions

Our findings provide preliminary evidence for the validity of AIMS in detecting TD among Sinhalaspeaking patients, when administered by a range of mental health professionals.