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Neurology. 2004 Jul 27;63(2):293-300.

Psychiatric comorbidities in patients with Parkinson disease and psychosis.

Author information

1
Department of Psychiatry and Behavioral Sciences, Morris K. Udall Parkinson's Disease Research Center of Excellence at Johns Hopkins, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. lmarsh@jhmi.edu

Abstract

OBJECTIVE:

To determine the prevalence and impact of comorbid psychiatric disturbances in Parkinson disease (PD) patients with psychosis.

METHODS:

Subject data were derived from a research database of 116 PD patients participating in standardized motor, cognitive, psychiatric, and caregiver assessments.

RESULTS:

There were 25 patients (22%) with psychosis manifest as hallucinations (n = 9), delusions (n = 1), or hallucinations and delusions (n = 15) and 25 patients (22%) who had no current or past psychiatric comorbidities (PDN). In the psychotic group, 44% had psychosis only (PSY), and 56% had psychosis plus at least one other comorbid psychiatric disturbance (PSY+), including depressive disorders (71%), anxiety disorders (21%), apathetic syndromes (14%), and delirium (14%). There were no differences in age, sex, education, or age onset or duration of PD among the PSY, PSY+, and PDN groups. Both psychotic groups had greater motor, functional, and frontal cognitive deficits and increased caregiver burden scores relative to PDN. PSY+ showed greater global and selective cognitive deficits compared to PDN. Psychosis was a primary predictor of caregiver burden, whereas depressive symptoms indirectly enhanced motor impairments.

CONCLUSIONS:

Nonpsychotic psychiatric disturbances, especially affective disturbances, are common comorbidities in PD patients with psychosis and warrant clinical attention to reduce morbidity and caregiver distress.

PMID:
15277623
[Indexed for MEDLINE]
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