Psychiatric symptoms screening in the early stages of Parkinson’s disease

Abstract

Psychiatric complaints are common in Parkinson's disease (PD), and have a significant influence in disease outcome and quality of life. Little attention has been paid to psychiatric symptoms at early stage disease. We aimed to screen a population of early stage PD patients for psychiatric symptoms and to study the relation with motor and cognitive function. Thirty-six early stage PD patients underwent motor [Hoehn and Yahr (HY), Unified Parkinson's Disease Rating Scale] and cognitive [Frontal Assessment Battery, Mini-Mental State Examination (MMSE)] assessment as well as general psychiatric [Symptom Check-List 90 (SCL-90-R)] and psychosis [Brief Psychiatric Rating Scale (BPRS)] screening. Relation between psychiatric domains scores was studied with principal component analysis. Relation between psychiatric, disease related, cognitive and motor function was assessed with bivariate correlation (Pearson). SCL-90-R scores were higher for somatization (significant scores in 66.7% of patients), depression (36.1%), anxiety (27%) and obsessive-compulsive symptoms (OCS) (52.8%). Scores were highly correlated, except for psychosis and phobia. Depression and anxiety were negatively correlated to MMSE score and dopaminergic doses, respectively. BPRS scores were higher for somatic concern, depression, anxiety and hallucinations. There was segregation between depression, anxiety, hallucinations, other positive psychotic symptoms and negative psychotic symptoms. Depression was related to MMSE score. We found a high prevalence of psychiatric complaints in PD patients, mostly related to depression, anxiety, somatization and OCS. Hallucinations were also frequent, but not associated to cognitive function or dopaminergic doses, suggesting a different physiopathological background.

Non-Motor symptoms in Portuguese Parkinson’s Disease patients: correlation and impact on Quality of Life and Activities of Daily Living

“…Psychosis prevalence was similar for NMSS and PPQ scales, and higher than in most studies. This was also detected in a previous investigation in early stage Portuguese PD patients, and could be related to the older mean age of our PD population7 or to the tendency to tolerate low intensity psychotic symptoms rather than using neuroleptics, which is suggested by the reduced number of patients who were under antipsychotics compared to those who scored positive in the psychosis scales.…”

“…Cognitive dysfunction, for instance, was found to be increased in populations with lower education levels4, the total prevalence of NMS was found to be increased in regions with less health care availability5 and the prevalence of hallucinations lower in countries with less access to dopaminergic treatment4. The relation between symptoms has also been assessed, suggesting a relation between cognitive deficits and non-tremor motor symptoms6; depression and cognitive dysfunction7; psychosis and sleep dysfunction89; apathy and depression or executive dysfunction10. However, many studies have focused only on a particular set of symptoms.…”

Impulse Control Disorders in Parkinson’s Disease: Crossroads between Neurology, Psychiatry and Neuroscience

“…Both Maia et al [29] and Harbishettar et al [30] did not find significant OCS in their PD patients. However, Alegret et al [31] found OCS to be especially prevalent in particular PD groups, while Bugalho et al [5] and Siri et al [32] found a higher percentage of OCS in PD, using the same psychopathological screening scale. Studies addressing the relation between OCS and ICDs in PD are even scarcer.…”

“…Psychiatric disorders, such as psychosis, depression and anxiety, are frequently found in PD [5]. The spectrum of behavioural disorders in PD has recently been widened to include a group of conditions known as impulse control disorders (ICDs).…”

Cognitive and Behavioural Changes After Deep Brain Stimulation of the Subthalamic Nucleus in Parkinson's Disease

“…In a recent study carried out in patients with Parkinson's disease in early stages, the prevalence of anxiety was about 27% (Bugalho et al, 2012).…”