Bipolar Spectrum disorders in Parkinson’s disease: a systematic evaluation

Abstract

Objective Psychiatric disorders are very common in patients affected by Parkinson’s disease (PD). However, comorbidity with Bipolar Spectrum disorders is understudied. The aim of this study is to explore the clinical correlates of PD associated with Bipolar Spectrum disorders. Methods One hundred PD patients were screened for psychiatric comorbidities, cognitive profile, motor, and non-motor symptoms. The sample was divided into three groups: PD-patients with Bipolar Spectrum disorders (bipolar disorder type I, type II, and spontaneous or induced hypomania; N = 32), PD-patients with others psychiatric comorbidities (N = 39), PD-patients without psychiatric comorbidities (N = 29). Clinical features were compared among the groups using analysis of variance and chi-square test. A logistic regression was performed to evaluate the association between Bipolar Spectrum disorders and early onset of PD (≤50 years) controlling for lifetime antipsychotic use. Results In comparison with PD patients with and without other psychiatric comorbidity, subjects affected by Bipolar Spectrum disorders were younger, showed more frequently an early onset PD, reported more involuntary movements and a higher rate of impulse control disorders and compulsive behaviors. No differences were observed in indexes of exposure to dopamine agonist treatments. The early onset of PD was predicted by Bipolar Spectrum comorbidity, independently from lifetime antipsychotic use. Conclusion Bipolar Spectrum disorders are common in early onset PD. The presence of bipolar comorbidity could identify a particular subtype of PD, showing higher rates of neurological and psychiatric complications and deserving further investigation.

Prevalence and Clinical Correlates of Comorbid Anxiety and Panic Disorders in Patients with Parkinson’s Disease

“…According to MINI-Plus, 42 patients had a history of a depressive episode, 26 of which met criteria for major depressive disorder. As previously reported, bipolar spectrum disorders (i.e., including drug-induced hypomania and unipolar hypomania) were diagnosed in 32 patients according to SIMD-R [ 25 ]. Overall, 26 (26%) patients were currently diagnosed with at least one anxiety disorder according to MINI-Plus, with GAD being the most frequent current anxiety disorder (15 of 100, 15%).…”

“…Thus, both patients with current anxiety disorders and patients who have ever satisfied criteria for panic disorder and/or agoraphobia over the course of life were included among patients with lifetime anxiety disorders. Other assessment instruments and further details on recruitment were previously described by Bacciardi et al [ 25 ].…”

Preexisting Bipolar Disorder Influences the Subsequent Phenotype of Parkinson's Disease

“…These studies suggested that the prevalence of BSDs in PD is higher than in control populations. Following the epidemiological reports, new studies addressed BSDs in PD, generically naming the described disorders as hypomania 42‐45 . Guided by earlier literature, 8‐27 and also because, in several legal instances, two senior authors of the present paper were asked to provide an earnest analysis for compensation claims, which were at the time prevalent on social and public media, 46‐49 we started testing all PD patients in our cohort using psychiatric scales and interviews to assess BSDs.…”

“…Following the epidemiological reports, new studies addressed BSDs in PD, generically naming the described disorders as hypomania. 42 , 43 , 44 , 45 Guided by earlier literature, 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 and also because, in several legal instances, two senior authors of the present paper were asked to provide an earnest analysis for compensation claims, which were at the time prevalent on social and public media, 46 , 47 , 48 , 49 we started testing all PD patients in our cohort using psychiatric scales and interviews to assess BSDs. When the last epidemiological studies were published, 35 , 36 we thought we could present our data for discussion.…”

Catatonia in two women with Parkinson’s disease treated with electroconvulsive therapy

“…Parkinson's disease (PD), historically defined as a movement disorder, is now considered the prototypical neuropsychiatric condition, in which motor signs, such as tremors, rigidity, and bradykinesia, occur together with cognitive and neuropsychiatric features [6]. Depression [7], bipolar disorder [8,9], psychosis [10], anxiety [11], impulse control disorders [12], apathy [13], and sleep disturbances [14] can frequently and significantly impact the course of PD. Despite the high psychiatric comorbidity reported in PD patients, few cases of catatonia have been reported in the literature [15][16][17][18].…”