Psychiatric comorbidities in patients with Parkinson disease and psychosis

Marsh, Laura; Williams, James R.; Rocco, M.; Grill, Stephen; Munro, Cynthia A.; Dawson, Ted M.

doi:10.1212/01.wnl.0000129843.15756.a3

Cited by 213 publications

(146 citation statements)

References 45 publications

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“…* It is often used in the relevant literature as a measure of caregiver burden [21][22]. Each caregiver completed the ZBI in approximately 15 minutes.…”

Section: Caregiver Burden Instrumentsmentioning

confidence: 99%

Caregiver distress in parkinsonism

Cifu¹,

Carne²,

Brown³

et al. 2006

JRRD

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Abstract-This study examined the frequency and degree of caregiver burden in persons with parkinsonism, a group of disorders with four primary symptoms that include tremor, rigidity, postural instability, and bradykinesia. We assessed associations between perceived caregiver burden and physical, cognitive, and functional impairments using well-established tools for persons with parkinsonism. The 49 individuals with parkinsonism ranged in age from 61 to 87 (mean = 75), while their caregivers (N = 49) ranged in age from 48 to 83 (mean = 70). The caregivers were predominantly either wives (82%) or daughters (6%), with other family members, friends, and/or neighbors (12%) making up the rest. The caregivers reported a relatively high ability for coping (mean scores = 4.6/6). Caregiver burden was significantly negatively associated with activities of daily living and motoric difficulties as measured on the Unified Parkinson's Disease Rating Scale (UPDRS). Likewise, caregiver burden was negatively associated with caregiver self-reported sleep and coping ability. Results did not demonstrate an association on the UPDRS among mentation, behavior, and mood. We found a significant negative correlation for mentation between the Folstein Mini-Mental Status Examination and caregiver burden measures; however, we did not find this association with the Dementia Rating Scale-2. Patient's self-reported pain and caregiver burden were not associated.

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“…* It is often used in the relevant literature as a measure of caregiver burden [21][22]. Each caregiver completed the ZBI in approximately 15 minutes.…”

Section: Caregiver Burden Instrumentsmentioning

confidence: 99%

Caregiver distress in parkinsonism

Cifu¹,

Carne²,

Brown³

et al. 2006

JRRD

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“…If the two disorders have similar risk factors or neurobiological underpinnings, the co-occurrence of psychosis and depression would be greater than expected by chance alone, and previous research suggests that there may be an association between the two disorders [4][5][6][7]. If so, this may be due to common risk factors, including increasing age [6,8], greater cognitive impairment [4,9], and greater PD severity [6,9]. Other purported risk factors for individual disorders include exposure to most dopaminergic therapies (psychosis) [10], and female sex, predominantly right-sided motor symptoms, and treatment with higher levodopa doses (depression) [9,11,12].…”

Section: Introductionmentioning

confidence: 99%

Frequency and correlates of co-morbid psychosis and depression in Parkinson's disease

Weintraub¹,

Morales²,

Duda³

et al. 2006

Parkinsonism & Related Disorders

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Though both psychosis and depression are common in Parkinson's disease (PD), it is not clear if an association between the two disorders exists. One hundred and thirty PD patients were divided into four groups based on a comprehensive psychiatric assessment: (1) no depression or psychosis (47.7%); (2) psychosis only (16.2%); (3) depression only (26.2%); and (4) psychosis and depression (10.0%). Co-morbid psychosis and depression did not occur more frequently than expected by chance (P = .77). Psychosis was associated with dopamine agonist use (P = .02), depression with mildcognitive impairment (P = .03), and their co-occurrence with higher daily levodopa dosages (P<.01). These results suggest that psychosis and depression in PD are distinct neurobehavioral disorders.

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“…9,22,23 Based on this, many studies have evaluated whether certain cognitive domains are preferentially impaired in PD patients with visual hallucinations. Executive impairment is most consistently reported to be impaired in psychotic patients with PD, 24,25 even in those without dementia. 26,27 It should be noted that these studies used different measures and assessed different aspects of executive dysfunction.…”

Section: Cognitive and Visual Impairmentmentioning

confidence: 99%

Risk Factors for Psychosis in Parkinson’s Disease

Barrett

2017

US Neurology

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Psychosis is a characteristic neuropsychiatric symptom of Parkinson's disease (PD) that is common and associated with worse outcomes. The purpose of this article is to review identified risk factors for visual hallucinations in PD, the most common manifestation of psychosis. With the possible exception of dopamine agonists, antiparkinsonian medications are only considered modifiers of psychosis in PD. Dementia in PD has consistently been shown to be associated with psychosis, and executive dysfunction and impairment in visual processing appear to play a role in its pathogenesis. The association of psychosis with disorders of sleep-wake dysregulation and autonomic dysfunction supports the involvement of brainstem dysfunction in PD psychosis. Despite many studies evaluating genetic risk factors for hallucinations, GBA mutations are the only variants consistently reported to be associated with an increased risk of hallucinations in PD. Lastly, psychosis in PD is associated with a more severe disease burden, both related and unrelated to PD pathology. Any explanatory model of psychosis in PD must incorporate pharmacological, neuroanatomic, pathological, and genetic factors before there can be a complete understanding of this common and disabling neuropsychiatric symptom. KeywordsParkinson's disease, psychosis, hallucinations, risk factor, dementia, rapid eye movement (REM) sleep behavior disorder Authorship: All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published.Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any non-commercial use, distribution, adaptation and reproduction provided the original author(s) and source are given appropriate credit. had minor hallucinations prior to PD motor symptom onset.3 In addition to being common, psychosis is also associated with worse outcomes: increased institutionalization, 4 decreased quality of life, 5 and increased mortality. Considering its prevalence and association with worse outcomes, many studies have sought to identify risk factors for psychosis, specifically visual hallucinations. These efforts have contributed to an improved understanding of this disabling neuropsychiatric symptom. Some risk factors, i.e. cognitive impairment and rapid eye movement (REM) sleep behavior disorder (RBD), may be integral to the mechanism by which psychotic symptoms emerge and have contributed to development of explanatory models of psychotic symptoms in PD. Other risk factors likely represent correlations arising from concomitant pathology in areas not involved in psychosis but occurring at a similar disease stage. Lastly, multiple studies have helped to clarify the relationship between antiparkinsonian medications, especially dopaminergic medications, and psychosis in PD.The purpose of this article is to review risk factors fo...

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Psychiatric comorbidities in patients with Parkinson disease and psychosis

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

Cited by 213 publications

References 45 publications

Caregiver distress in parkinsonism

Caregiver distress in parkinsonism

Frequency and correlates of co-morbid psychosis and depression in Parkinson's disease

Risk Factors for Psychosis in Parkinson’s Disease

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