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Psychosis is one of the most critical and frequently occurring complications in patients with advanced-stage PD and has a significant impact on health-related quality of life. Furthermore, psychosis is the main risk factor for nursing home placement and is associated with a high mortality. 2 The cross-sectional prevalence of psychosis in patients with PD is in the range of 25%-30%. 3 Antiparkinsonian medications contribute to psychosis, however that may not be all. It was also pointed out that visual hallucinations and delusions are associated with Lewy body pathology. 4-6 The underlying causes of psychosis in PD involve a complex interplay between exogenous (eg, medication, comorbidity) and endogenous (eg, PD disease pathology) factors. 7 Previous studies reported that psychosis was associated with advanced age, later stages of PD, cognitive impairment, and depression. 8 However, the relationship between psychosis and the other clinical parameters is not well-understood. Here, we have investigated patients with advanced-stage PD to clarify the factors associated with psychosis in this population.

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