[Neuropsychiatric problems in patients with Parkinson's disease].

OBJECTIVE

To survey the prevalence and distribution of neuropsychiatric problems in patients with Parkinson's disease (PD), and to investigate their effects on life quality and the interactions among different neuropsychiatric problems.

METHODS

Unified Parkinson's disease rating scale (UPDRS) part III, dyskinesia and motor fluctuation subscale of UPDRS part IV, mini-mental state examination (MMSE) ,Montreal Cognitive Assessment (MoCA), Hamilton rate scale of depression (HRSD), Hamilton anxiety scale (HAMA), digit span (DS), and 39 item Parkinson's disease questionnaire (PDQ-39) were used to assess the motor symptoms and neuropsychiatric problems in 116 PD patients, 66 males and 50 females, aged (67 +/- 9) (50-90), with the course of disease of 5 +/- 4 years (0.5--18 years). Spearman rank order correlation and hierarchical regressions of the major statistical procedures were employed.

RESULTS

Various neuropsychiatric problems were found in the PD patients. The neuropsychiatric problems, such as depression, anxiety, apathy, attention deficit disorder, and cognitive deficits, were correlated with the UPDRS III score and Hoehn-Yahr stage, but not correlated with the course of disease ( all P > 0.05). Hallucination was not correlated with any factors (all P > 0.05). There were some correlations among different neuropsychiatric problems. Hierarchical regression revealed that different neuropsychiatric problems showed significant effects on the quality of life after controlling the motor symptoms. Depression (deltaR2 = 19.1%, P < 0.01) and apathy (deltaR2 = 17.0%, P < 0.01) exerted the most powerful influence in causing poor quality of life.

CONCLUSION

Neuropsychiatric problems are common a in PD patients Their effects on the poor quality of life are no less than that of motor symptoms and should be recognized and treated well.