Neuropsychiatric symptoms in Parkinson's disease: aetiology, diagnosis and treatment

Abstract

SUMMARY Historically, Parkinson's disease was viewed as a motor disorder and it is only in recent years that the spectrum of non-motor disorders associated with the condition has been fully recognised. There is a broad scope of neuropsychiatric manifestations, including depression, anxiety, apathy, psychosis and cognitive impairment. Patients are more predisposed to delirium, and Parkinson's disease treatments give rise to specific syndromes, including impulse control disorders, dopamine agonist withdrawal syndrome and dopamine dysregulation syndrome. This article gives a broad overview of the spectrum of these conditions, describes the association with severity of Parkinson's disease and the degree to which dopaminergic degeneration and/or treatment influence symptoms. We highlight useful assessment scales that inform diagnosis and current treatment strategies to ameliorate these troublesome symptoms, which frequently negatively affect quality of life.

Neuroscience: the way forward

“…This special issue of BJPsych Advances illustrates some of the diversity of impact of modern neuroscience on psychiatry. Particularly thought-provoking contributions explore state-of-the-art knowledge of the complex biology behind substance misuse (Hayes 2020), some of the challenges associated with benzodiazepine pharmacotherapy in depression (Cates 2020) and the neuropsychiatric sequelae of Parkinson's disease (Jones 2020).…”

Use of common spatial patterns for early detection of Parkinson’s disease

“…Manifestation of the PD differs among individuals, but cardinal signs of the PD are related to motor dysfunction, such as hypokinesia, resting tremors, problems with starting or also stopping the movement, lead pipe rigidity, and mask face and postural reflex impairment 9 . In addition to motor symptoms also non-motor symptoms, such as depression, anxiety, psychosis, apathy and/or impulse control disorders manifest in PD patients 10 , 11 . The manifestations of the PD change with passing of time, but the progress is related to the age of the patient rather than the age of the onset of the disease 12 .…”

Prediction of Cognitive Decline by Behavioral Symptoms in Neuropsychiatric Disorders

“…Approximately one-third of Parkinson's patients suffer from anxiety disorders. Al-though different aspects of cognition are affected in this disease, neuropsychiatric manifestations also significantly impact the patient's performance and usually appear before other disease symptoms (6). Several sleep problems are associated with AD, including fragmentation of nocturnal sleep, insomnia, diurnal drowsiness, and circadian rhythm sleep disorder (7).…”