Funding agencies: This work was supported, in part, by grants from the National Institute of Mental Health (067894) and the Mental Illness Research, Education, and Clinical Center at the Philadelphia Veterans Affairs Medical Center.
Article first published online: 1 JUN 2012
Copyright © 2012 Movement Disorder Society
Volume 27, Issue 7, pages 858–863, June 2012
How to Cite
Lee, A. H. and Weintraub, D. (2012), Psychosis in Parkinson's disease without dementia: Common and comorbid with other non-motor symptoms. Mov. Disord., 27: 858–863. doi: 10.1002/mds.25003
Relevant conflicts of interest/financial disclosures: Nothing to report.
Full financial disclosures and author roles may be found in the online version of this article.
- Issue published online: 20 JUN 2012
- Article first published online: 1 JUN 2012
- Manuscript Accepted: 20 MAR 2012
- Manuscript Revised: 15 MAR 2012
- Manuscript Received: 26 JAN 2012
- Parkinson's disease;
- cognitively intact
Psychosis in Parkinson's disease (PD) is common and associated with a range of negative outcomes. Dementia and psychosis are highly correlated in PD, but the frequency and correlates of psychosis in patients without cognitive impairment are not well understood. One hundred and ninety-one non-demented PD patients at two movement disorders centers participated in a study of neuropsychiatric complications in PD and completed a detailed neurological and neuropsychiatric assessment, including the rater-administered Parkinson Psychosis Rating Scale for hallucinations, delusions, and minor symptoms of psychosis (illusions and misidentification of persons). Psychotic symptoms were present in 21.5% of the sample. Visual hallucinations were most common (13.6%), followed by auditory hallucinations (6.8%), illusions or misidentification of people (7.3%), and paranoid ideation (4.7%). Visual hallucinations and illusions or misidentification of people were the most common comorbid symptoms (3.1%). Depression (P = 0.01) and rapid eye movement behavior disorder symptoms (P = 0.03) were associated with psychosis in a multivariable model. The odds of experiencing psychotic symptoms were approximately five times higher in patients with comorbid disorders of depression and sleep-wakefulness. Even in patients without global cognitive impairment, psychosis in PD is common and most highly correlated with other non-motor symptoms. Screening for psychosis should occur at all stages of PD as part of a broad non-motor assessment. In addition, these findings suggest a common neural substrate for disturbances of perception, mood, sleep-wakefulness, and incipient cognitive decline in PD. © 2012 Movement Disorder Society