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Objectives-To determine the prevalence of psychotic phenomena, including minor symptoms, in a Parkinson's disease (PD) sample and compare the clinical correlates associated with the various psychotic phenomena. To evaluate the extent to which cases met NINDS/NIMH proposed criteria for PD-associated psychosis.Methods-250 patients with idiopathic PD and MMSE>23 from three community-based movement disorder clinics underwent comprehensive research diagnostic evaluations by a geriatric psychiatrist as part of a study on mood disorders in PD. Psychotic symptoms were categorized using a checklist, which included a breakdown of hallucinations, delusions and minor symptoms. Clinical characteristics of groups with minor and other psychotic symptoms were compared. The NINDS/NIMH criteria for PD-psychosis were retrospectively applied.Results-Of the total sample, 26% of patients were found to have any current psychotic symptoms, with 47.7% of those having isolated minor symptoms, and 52.3% having hallucinations and/or delusions. Compared to those with no current psychiatric symptoms, minor symptoms were associated with more depressive symptoms and worse quality of life. 90.8% of those with psychotic symptoms fulfilled the NINDS/NIMH proposed criteria.Conclusions-Psychotic symptoms are common in PD patients, with minor psychotic phenomena present in nearly half of affected patients in a community-based sample. Psychotic symptoms, including minor phenomena, were clinically significant. The NINDS/NIMH PD- Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. ObjectivesPatients with Parkinson's disease (PD) commonly experience neuropsychiatric symptoms [1,2]. Psychotic symptoms are especially prevalent, and are associated with greater physical disability, cognitive and affective dysfunction, caregiver distress, nursing home placement, and mortality [3][4][5]. However, the temporal and clinical profile of psychosis in PD is different from other psychotic disorders, such as schizophrenia or mood disorders with psychotic features. Therefore, definitions and schemas applied to other psychiatric illnesses have limited utility for describing and quantifying the scope of psychotic phenomena in PD.Psychotic symptoms in PD include hallucinations and delusions, which define psychosis typically. There are also atypical symptoms, referred to as minor psychotic phenomena, which include sense of presence, passage hallucinations, and illusions (see Appendix). Furthermore, hallucinations are usually visual, although other sensory modalities can be involved. Cross-sectional prevalence estimates indicat...

Objective Neither best practices nor an evidence-base for the pharmacologic treatment of anxiety in Parkinson's disease has been established. This study investigated pharmacologic treatment of anxiety disorders in idiopathic Parkinson's disease and the associated clinical features. Design Cross-sectional. Setting Three community-based movement disorder neurology practices Participants 250 subjects with Parkinson's disease. Measurements Anxiety disorder diagnoses were established by consensus using a panel of six psychiatrists with expertise in geriatric psychiatry and movement disorders. Current medications were provided by the treating neurologists at the time of interview. Results Amongst subjects with anxiety disorders only, 53% were untreated with medications. However, when anxious subjects with comorbid depressive disorders were included, 70.8% were on medications effective for treatment of anxiety. Subjects with anxiety and comorbid depressive disorders were more likely to be treated for their psychiatric disturbances than subjects with anxiety disorders alone (Odds Ratio 8.33) as were subjects with comorbid motor fluctuations (Odds Ratio, 3.65). There were no differences in the types of anti-anxiety medications used in regard to the presence of depression or motor fluctuations. Conclusions These findings suggest that over half of non-depressed Parkinson's disease patients with clinically significant anxiety are untreated with medication. A better understanding of the role of clinical features associated with anxiety in PD, such as depression and motor fluctuations, may improve the recognition and treatment of anxiety disorders in this population.