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

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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.

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References

  1. Aarsland D, Larsen JP, Cummins JL, Laake K (1999) Prevalence and clinical correlates of psychotic symptoms in Parkinson disease: a community-based study. Arch Neurol 56(5):595–601

    Article  PubMed  CAS  Google Scholar 

  2. Aarsland D, Larsen JP, Lim NG et al (1999) Range of neuropsychiatric disturbances in patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry 67(4):492–496

    Article  PubMed  CAS  Google Scholar 

  3. Aarsland D, Brønnick K, Alves G et al (2009) The spectrum of neuropsychiatric symptoms in patients with early untreated Parkinson’s disease. J Neurol Neurosurg Psychiatry 80(8):928–930

    Article  PubMed  CAS  Google Scholar 

  4. Alegret M, Junqué C, Valldeoriola F, Vendrell P, Martí MJ, Tolosa E (2001) Obsessive-compulsive symptoms in Parkinson’s disease. J Neurol Neurosurg Psychiatry 70(3):394–396

    Article  PubMed  CAS  Google Scholar 

  5. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorder, 4th ed edn. APA, Washington

    Google Scholar 

  6. Braak H, Del Tredici K, Rüb U, de Vos RA, Jansen Steur EN, Braak E (2003) Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging 24(2):197–211

    Article  PubMed  Google Scholar 

  7. Derogatis LR (1977) Symptom check list-90 revised. Administration scoring and procedures manual. Clinical Psychometrics Unit, Johns Hopkins University, Baltimore

    Google Scholar 

  8. Dissanayaka NN, Sellbach A, Matheson S, O’Sullivan JD, Silburn PA, Byrne GJ, Marsh R, Mellick GD (2010) Anxiety disorders in Parkinson’s disease: prevalence and risk factors. Mov Disord 25(7):838–845

    Article  PubMed  Google Scholar 

  9. Dubois B, Slachevsky A, Litvan I, Pillon B (2000) The FAB: a frontal assessment battery at bedside. Neurology 55:1621–1626

    PubMed  CAS  Google Scholar 

  10. Dubois B, Burn D, Goetz C et al (2007) Diagnostic procedures for Parkinson’s disease dementia: recommendations from the Movement Disorder Society Task Force. Mov Disord 22(16):2314–2324

    Article  PubMed  Google Scholar 

  11. Fahn S, Elton RL, and members of the UPDRS Development Committee (1987) Unified Parkinson’s Disease Rating Scale. In: Fahn S, Marsden CD, Calne DB, Goldstein M (eds) Recent Developments in Parkinson’s Disease. Macmollan Health Care Information, Florham Park, pp 153–163, 293–304

    Google Scholar 

  12. Fénelon G, Mahieux F, Huon R, Ziégler M (2000) Hallucinations in Parkinson’s disease: prevalence, phenomenology and risk factors. Brain 123(Pt 4):733–745

    Article  PubMed  Google Scholar 

  13. Fernandez HH, Aarsland D, Fénelon G, Friedman JH, Marsh L, Tröster AI et al (2008) Scales to assess psychosis in Parkinson’s disease: critique and recommendations. Mov Disord 23(4):484–500

    Article  PubMed  Google Scholar 

  14. Folstein M, Folstein S, McHugh P (1975) Mini-mental state a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198

    Article  PubMed  CAS  Google Scholar 

  15. Friedman A (1994) Old-onset Parkinson’s disease compared with young-onset disease: clinical differences and similarities. Acta Neurol Scand 89(4):258–261

    Article  PubMed  CAS  Google Scholar 

  16. Gelb DJ, Oliver E, Gilman S (1999) Diagnostic criteria for Parkinson’s disease. Arch Neurol 56:33–39

    Article  PubMed  CAS  Google Scholar 

  17. Graham JM, Grünewald RA, Sagar HJ (1997) Hallucinosis in idiopathic Parkinson’s disease. J Neurol Neurosurg Psychiatry 63(4):434–440

    Article  PubMed  CAS  Google Scholar 

  18. Harbishettar V, Pal PK, Janardhan Reddy YC, Thennarasu K (2005) Is there a relationship between Parkinson’s disease and obsessive-compulsive disorder? Parkinsonism Relat Disord 11(2):85–88

    Article  PubMed  Google Scholar 

  19. Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression and mortality. Neurology 17:427–442

    PubMed  CAS  Google Scholar 

  20. Jankovic J, McDermott M, Carter J et al (1990) Variable expression of Parkinson’s disease: a base-line analysis of the DATATOP cohort. Neurology 40(10):1529–1534

    PubMed  CAS  Google Scholar 

  21. Kenangil G, Orken DN, Ur E, Forta H (2010) Frontal assessment battery in patients with Parkinson disease in a Turkish population. Cogn Behav Neurol 23(1):26–28

    Article  PubMed  Google Scholar 

  22. Kostić VS, Agosta F, Petrović I et al (2010) Regional patterns of brain tissue loss associated with depression in Parkinson disease. Neurology 75(10):857–863

    Article  PubMed  Google Scholar 

  23. Kulisevsky J, Pagonabarraga J, Pascual-Sedano B, García-Sánchez C, Gironell A, Trapecio Group Study (2008) Prevalence and correlates of neuropsychiatric symptoms in Parkinson’s disease without dementia. Mov Disord 23(13):1889–1896

    Article  PubMed  Google Scholar 

  24. Maia AF, Pinto AS, Barbosa ER, Menezes PR, Miguel EC (2003) Obsessive compulsive symptoms, obsessive-compulsive disorder, and related disorders in Parkinson’s disease. J Neuropsychiatry Clin Neurosci 15(3):371–374

    Article  PubMed  Google Scholar 

  25. McGuire PK (1995) The brain in obsessive-compulsive disorder. J Neurol Neurosurg Psychiatry 59:457–459

    Article  PubMed  CAS  Google Scholar 

  26. McKinlay A, Grace RC, Dalrymple-Alford JC, Anderson T, Fink J, Roger D (2008) A profile of neuropsychiatric problems and their relationship to quality of life for Parkinson’s disease patients without dementia. Parkinsonism Relat Disord 14(1):37–42

    Article  PubMed  CAS  Google Scholar 

  27. Nègre-Pagès L, Grandjean H, Lapeyre-Mestre M, Montastruc JL, Fourrier A, Lépine JP, Rascol O, DoPaMiP Study Group (2010) Anxious and depressive symptoms in Parkinson’s disease: the French cross-sectionnal DoPaMiP study. Mov Disord 25(2):157–166

    Article  PubMed  Google Scholar 

  28. Onofrj M, Bonanni L, Manzoli L, Thomas A (2010) Cohort study on somatoform disorders in Parkinson disease and dementia with Lewy bodies. Neurology 74(20):1598–1606

    Article  PubMed  Google Scholar 

  29. Overall JE, Gorham DR (1988) The Brief Psychiatric Rating Scale (BPRS): recent developments in ascertainment and scaling. Psychopharmacol Bull 24:97–99

    Google Scholar 

  30. Parkin SG, Gregory RP, Scott R et al (2002) Unilateral and bilateral pallidotomy for idiopathic Parkinson’s disease: a case series of 115. Mov Disord 17:682–692

    Article  PubMed  Google Scholar 

  31. Pontone GM, Williams JR, Anderson KE et al (2009) Prevalence of anxiety disorders and anxiety subtypes in patients with Parkinson’s disease. Mov Disord 24(9):1333–1338

    Article  PubMed  Google Scholar 

  32. Sanchez-Ramos JR, Ortoll R, Paulson GW (1996) Visual hallucinations associated with Parkinson disease. Arch Neurol 53(12):1265–1268

    Article  PubMed  CAS  Google Scholar 

  33. Schiffer RB, Kurlan R, Rubin A, Boer S (1988) Evidence for atypical depression in Parkinson’s disease. Am J Psychiatry 145(8):1020–1022

    PubMed  CAS  Google Scholar 

  34. Siri C, Cilia R, De Gaspari D et al (2010) Psychiatric symptoms in Parkinson’s disease assessed with the SCL-90R self-reported questionnaire. Neurol Sci 31(1):35–40

    Article  PubMed  Google Scholar 

  35. Takagi R, Kajimoto Y, Kamiyoshi S, Miwa H, Kondo T (2002) The frontal assessment battery at bedside (FAB) in patients with Parkinson’s disease. No To Shinkei 54(10):897–902

    PubMed  Google Scholar 

  36. Tandberg E, Larsen JP, Aarsland D, Cummings JL (1996) The occurrence of depression in Parkinson’s disease. A community-based study. Arch Neurol 53(2):175–179

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Neurology Department, Hospital de Egas Moniz (CHLO), Rua da Junqueira, 126, 1349-019, Lisbon, Portugal

    Paulo Bugalho

  2. Neurology Department, Faculdade de Ciências Médicas de Lisboa, Lisbon, Portugal

    Paulo Bugalho

  3. Psychiatry Department, Hospital de S. Francisco Xavier (CHLO), Lisbon, Portugal

    Joaquim Alves da Silva, Inês Cargaleiro, Madalena Serra & Bernardo Neto

  4. Psychiatry Department, Faculdade de Ciências Médicas de Lisboa, Lisbon, Portugal

    Joaquim Alves da Silva

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  1. Paulo Bugalho
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  2. Joaquim Alves da Silva
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  3. Inês Cargaleiro
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  4. Madalena Serra
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  5. Bernardo Neto
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Correspondence to Paulo Bugalho.

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Bugalho, P., da Silva, J.A., Cargaleiro, I. et al. Psychiatric symptoms screening in the early stages of Parkinson’s disease. J Neurol 259, 124–131 (2012). https://doi.org/10.1007/s00415-011-6140-8

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  • DOI: https://doi.org/10.1007/s00415-011-6140-8

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