Hostname: page-component-848d4c4894-2xdlg Total loading time: 0 Render date: 2024-06-20T15:23:39.402Z Has data issue: false hasContentIssue false

Farsi version of the Neuropsychiatric Inventory: validity and reliability study among Iranian elderly with dementia

Published online by Cambridge University Press:  14 October 2011

Seyed Kazem Malakouti
Tehran University of Medical Sciences, Mental Health Research Centre, Tehran, Iran
Lili Panaghi
Shahid Beheshti, Family Research Center. Tehran, Iran
Mahshid Foroughan*
Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
Masoumeh Salehi
Iran Alzheimer Association, Tehran, Iran
Taher Zandi
State University of New York College at Plattsburgh, Plattsburgh, NY, USA
Correspondence should be addressed to: Foroughan Mahshid, MD, University of Social Welfare and Rehabilitation Sciences, Kudakyar St, Daneshjoo Blvd, Evin, zip code: 1985713831, Tehran, Iran. Phone/fax: +98 21 22180004. Email:


Background: This study aimed to validate the Farsi version of Neuropsychiatric Inventory (F-NPI), with the aim of promoting clinical assessment and local research on evaluation of neuropsychiatric symptom profiles of individuals with dementia in Iran.

Methods: In this cross-sectional, psychometric study, 100 patients with dementia in the age range of 60–90 years participated. Two trained psychiatrists interviewed the study subjects. Positive and Negative Symptoms Scale (PANSS) and Geriatric Depression Scale (GDS) were used to determine the concurrent validity. Test-retest, inter-rater reliability and internal consistency were calculated. Discrimination validity was determined, using a matched control group consisting of 49 participants without dementia. Cronbach's α and Pearson's correlation coefficients were used to analyze the data.

Results: The internal consistency (Cronbach's α = 0.9) was excellent. The inter-rater reliability varied between 0.6 and 0.98 for frequency, severity and total scale of the F-NPI, and test-retest reliability was between 0.4 and 0.96. Concurrent validity varied between 0.3 and 0.9 (P < 0.05). The most prevalent symptom was “apathy” and the least prevalent was “euphoria”.

Conclusion: The Farsi version of NPI has satisfactory psychometric indexes and is applicable for clinical and study works in Iranian community.

Research Article
Copyright © International Psychogeriatric Association 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Abbasi, S. H. et al. (2010). The effect of mirtazapine add-on therapy to risperidone in the treatment of schizophrenia: a double-blind randomized placebo-controlled trial. Schizophrenia Research, 116, 101106.CrossRefGoogle ScholarPubMed
Akhondzadeh, S., Rezaei, F., Larijani, B., Nejatisafa, A. A., Kashani, L. and Abbasi, S. H. (2006). Correlation between testosterone, gonadotropins and prolactin and severity of negative symptoms in male patients with chronic schizophrenia. Schizophrenia Research, 84, 405415.CrossRefGoogle ScholarPubMed
Amini, H., Alimadadi, Z., Nejatisafa, A., Sharifi, V. and Ahmadi-Abhari, S. A. (2009). Quality of life in a group of patient with bipolar disorder and some of their clinical characteristics. Iranian Journal of Psychiatry and Clinical Psychology, 15, 175182.Google Scholar
Ansari, N. N., Naghdi, S., Hasson, S., Valizadeh, L. and Jalaie, S. (2010). Validation of a Mini-Mental State Examination (MMSE) for the Persian population: a pilot study. Applied Neuropsychology, 17, 190195.Google ScholarPubMed
Boada, M., Tarraga, L., Modinos, G., Lopez, O. L. and Cummings, J. L. (2005). Neuropsychiatric Inventory-Nursing Home version (NPI-NH): Spanish validation. Neurologia, 20, 665673.Google ScholarPubMed
Camozzato, A. L. et al. (2008). Reliability of the Brazilian Portuguese version of the Neuropsychiatric Inventory (NPI) for patients with Alzheimer's disease and their caregivers. International Psychogeriatrics, 20, 383393.CrossRefGoogle ScholarPubMed
Choi, S. H., , D. L., Kwon, H. M., Yoon, S. J., Jeong, J. H. and Ha, C-K. (2000). The Korean version of the Neuropsychiatric Inventory: a scoring tool for neuropsychiatric disturbance in dementia patients. Journal of Korean Medical Science, 15, 609615.CrossRefGoogle ScholarPubMed
Conn, D. and Thorpe, L. (2007). Assessment of behavioral and psychological symptoms associated with dementia. Canadian Journal of Neurological Sciences, 34, S6771.CrossRefGoogle ScholarPubMed
Conner, D. J., Sabbagh, M. N. and Cummings, J. L. (2008). Comment on administration and scoring of the Neuropsychiatric Inventory (NPI) in clinical trials. Alzheimer's & Dementia, 4, 390394.CrossRefGoogle Scholar
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 23082314.CrossRefGoogle ScholarPubMed
Folstein, M. F., Fostein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle ScholarPubMed
Foroughan, M., Jafari, Z., Shirinbayan, P., Ghaem Magham Farahni, Z. and Rahgozar, M. (2008). Standardization of Mini-Mental State Examination among Iranian elderly in Tehran. Cognitive Sciences, 10, 2937 [in Farsi].Google Scholar
Fuh, J. L., Liu, C. K., Mega, M. S., Wang, S. J. and Cummings, J. L. (2001). Behavioral disorders and caregivers’ reaction in Taiwanese patients with Alzheimer's disease. International Psychogeriatrics, 13, 121128.CrossRefGoogle ScholarPubMed
Fuh, J. L., Wang, S. J. and Cummings, J. L. (2005). Neuropsychiatric profiles in patients with Alzheimer's disease and vascular dementia. Journal of Neurology, Neurosurgery and Psychiatry, 76, 13371341.CrossRefGoogle ScholarPubMed
Hope, T., Keene, J., Fairburn, C. G., Jacoby, R. and McShane, R. (1999). Natural history of behavioral changes and psychiatric symptoms in Alzheimer's disease: a longitudinal study. British Journal of Psychiatry, 174, 3944.CrossRefGoogle ScholarPubMed
Kang, S. J., Choi, S. H., Lee, B. H., Jeong, Y., Hahm, D. S., Han, I. W. and Cummings, J. L. (2004). Caregiver-Administered Neuropsychiatric Inventory (CGA-NPI). Journal of Geriatric Psychiatry and Neurology, 17, 3235.CrossRefGoogle ScholarPubMed
Kaufer, D. I. et al. (1998). Assessing the impact of neuropsychiatric symptoms in Alzheimer's disease: the Neuropsychiatric Inventory Caregiver Distress Scale. Journal of the American Geriatrics Society, 46, 210215.CrossRefGoogle ScholarPubMed
Kaufer, D. I. et al. (2000). Validation of the NPI-Q: a brief clinical form of the Neuropsychiatric Inventory. Journal of Neuropsychiatry and Clinical Neuroscience, 12, 233239.CrossRefGoogle ScholarPubMed
Leung, V. P., Lam, L. C., Chiu, H. F., Cummings, J. L. and Chen, Q. L. (2001). Validation study of Chinese version of the Neuropsychiatric Inventory (CNPI). International Journal of Geriatric Psychiatry, 16, 789793.CrossRefGoogle ScholarPubMed
Malakouti, S. K., Fatollahi, P., Mirabzadeh, A., Salavati, M. and Zandi, T. (2006). Reliability, validity and factor structure of the GDS-15 in Iranian elderly. International Journal of Geriatric Psychiatry, 21, 588593.CrossRefGoogle ScholarPubMed
Malakouti, S. K. et al. (2009). Case-management for patients with schizophrenia in Iran: a comparative study of the clinical outcomes of mental health workers and consumers’ family members as case managers. Community Mental Health Journal, 45, 447452. doi: 10.1007/s10597-009-9197-4.CrossRefGoogle ScholarPubMed
Noorbala, A. A., Akhondzadeh, S., Davari-Ashtiani, R. and Amini-Nooshabadi, H. (1999). Piracetam in the treatment of schizophrenia: implications for the glutamate hypothesis of schizophrenia. Journal of Clinical Pharmacotherapy, 24, 369374.Google ScholarPubMed
Schulz, R. and O’ Brien, A. T. (1995). Psychiatric and physical morbidity effects of dementia caregiving: prevalence, correlates, and causes. Gerontologist, 35, 771791.CrossRefGoogle ScholarPubMed
Selbaek, G., Kirkevold, O., Sommer, O. H. and Engedal, K. (2008). The reliability and validity of the Norwegian version of the Neuropsychiatric Inventory–Nursing Home version (NPI-NH). International Psychogeriatrics, 20, 375382.CrossRefGoogle ScholarPubMed
Shah, A., Dalvi, M. and Thompson, T. (2005). Behavioral and psychological signs and symptoms of dementia across cultures: current status and the future. International Journal of Geriatric Psychiatry, 20, 11871195.CrossRefGoogle ScholarPubMed
Sheikh, J. and Yesavage, J. (1986). Geriatric Depression Scale: recent findings and development of a short version. In Brink, T. (ed.), Clinical Gerontology: A Guide to Assessment and Intervention. New York: Howarth Press.Google Scholar
Wood, S. et al. (2000). The use of Neuropsychiatric Inventory in nursing home residents: characterization and measurement. American Journal of Geriatric Psychiatry, 8, 7583.CrossRefGoogle ScholarPubMed
Yener, G. G and the Turkuaz Alzheimer Working Group (2009). The neuropsychiatric inventory scores change across the Mini-Mental State Examination range in patients with Alzheimer's disease: a multisite study in Turkey. Cognitive Behavioral Neurology, 22, 264269.CrossRefGoogle Scholar