The Hillside Akathisia Scale: a reliability comparison of the English and German versions

Abstract

Akathisia usually consists of two components, subjective restlessness and typical movements such as shuffling of the legs, pacing, shifting weight from one leg to the other, and rocking movements of the trunk. The ability to measure akathisia reliably is essential for the assessment of treatments for akathisia and for the evaluation of drug-induced side effects in general. To date, investigators have generally used self-constructed assessment scales without reporting data about reliability or validity. The Hillside Akathisia Scale (HAS) has two subjective and three objective items for which anchored rating points are provided. Reliability was 0.89 for the HAS total score. Reliability for rating subjective symptoms ranged from 0.86 to 0.92, and the objective scores ranged from 0.51 to 0.89. The correlation between HAS and a global assessment of akathisia (modified CGI) was 0.87. These values compare favorably with the original report on the scale indicating that the Hillside Akathisia Scale can validly quantify akathisia with a satisfactory degree of interrater reliability.

Evaluation of akathisia in patients with schizophrenia, schizoaffective disorder, or bipolar I disorder: a post hoc analysis of pooled data from short- and long-term aripiprazole trials

“…Some signs and symptoms of akathisia may closely resemble those of other conditions, including anxiety, agitation, insomnia, drug withdrawal states, restless legs syndrome, and tardive dyskinesia (Miller and Fleischhacker, 2000), contributing to either under recognition or misdiagnosis of this condition. The Barnes Akathisia Rating Scale (BARS) is the most widely used validated akathisia measurement scale and systematically assesses both overt movement behaviors and subjective aspects of akathisia (Barnes, 1989(Barnes, , 2003Fleischhacker et al, 1991;Inada et al, 2003;Loonen et al, 2001;Sachdev, 1994).…”

Family history of primary movement disorders as a predictor for neuroleptic-induced extrapyramidal symptoms

“…Each participant underwent a complete neurological examination with particular emphasis on specific signs of acute dystonic reaction, parkinsonism, akathisia and tardive dyskinesia. The following rating scales were used to assess the severity of extrapyramidal symptoms (van Harten et al , 1997): the Abnormal Involuntary Movement Scale (AIMS; National Institute of Mental Health, 1975); the Tsui Rating Scale for Cervical Dystonia (Tsui et al , 1986) and the Burke Rating Scale for Primary Torsion Dystonias (Burke et al , 1985); Part III of the Unified Parkinson's Disease Rating Scale (UPDRS; Movement Disorder Society Task Force on Rating Scales for Parkinson's Disease, 2003); the global score on the Hillside Scale (Fleischhacker et al , 1991) and the Barnes Akathisia Scale (Barnes, 1989). History of extrapyramidal symptoms on previous neuroleptic treatment was explored in a structured interview developed by our group, covering the typical symptoms of acute dystonic reaction, parkinsonism, akathisia and tardive dyskinesia.…”

Antipsychotic-induced akathisia in delirium: A systematic review

“…Clinical evaluation is essential in detection of akathisia. Nevertheless, several validated scales are available for diagnosis and assessment of the severity of akathisia: the Barnes Akathisia Rating Scale (Barnes & Braude, 1985), the Hillside Akathisia Scale (Fleischhacker et al, 1991), and the Prince Henry Akathisia Scale (Sachdev, 1994). The Barnes Akathisia Rating Scale (BAS) is the most commonly used assessment tool in clinical practice (Barnes & Braude, 1985).…”