Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Mov Disord. 2012 Jun;27(7):858-63. doi: 10.1002/mds.25003. Epub 2012 Jun 1.
Psychosis in Parkinson's disease (PD) is common and associated with a range of negative outcomes. Dementia and psychosis are highly correlated in PD, but the frequency and correlates of psychosis in patients without cognitive impairment are not well understood. One hundred and ninety-one non-demented PD patients at two movement disorders centers participated in a study of neuropsychiatric complications in PD and completed a detailed neurological and neuropsychiatric assessment, including the rater-administered Parkinson Psychosis Rating Scale for hallucinations, delusions, and minor symptoms of psychosis (illusions and misidentification of persons). Psychotic symptoms were present in 21.5% of the sample. Visual hallucinations were most common (13.6%), followed by auditory hallucinations (6.8%), illusions or misidentification of people (7.3%), and paranoid ideation (4.7%). Visual hallucinations and illusions or misidentification of people were the most common comorbid symptoms (3.1%). Depression (P = 0.01) and rapid eye movement behavior disorder symptoms (P = 0.03) were associated with psychosis in a multivariable model. The odds of experiencing psychotic symptoms were approximately five times higher in patients with comorbid disorders of depression and sleep-wakefulness. Even in patients without global cognitive impairment, psychosis in PD is common and most highly correlated with other non-motor symptoms. Screening for psychosis should occur at all stages of PD as part of a broad non-motor assessment. In addition, these findings suggest a common neural substrate for disturbances of perception, mood, sleep-wakefulness, and incipient cognitive decline in PD.
帕金森病（PD）中的精神病很常见，与一系列负面结果相关。痴呆症和精神病在 PD 中高度相关，但在没有认知障碍的患者中，精神病的频率和相关因素尚不清楚。来自两个运动障碍中心的 191 名非痴呆 PD 患者参加了一项 PD 神经精神并发症研究，并完成了详细的神经和神经精神评估，包括由评估者管理的幻觉、妄想和轻微精神病症状的帕金森精神病评定量表（幻觉、错觉和人员身份识别错误）。该样本中有 21.5%的患者存在精神病症状。视觉幻觉最为常见（13.6%），其次是听觉幻觉（6.8%）、错觉或人员身份识别错误（7.3%）和偏执观念（4.7%）。视觉幻觉和人员身份识别错误是最常见的共病症状（3.1%）。在多变量模型中，抑郁（P=0.01）和快速眼动行为障碍症状（P=0.03）与精神病相关。在同时患有抑郁和睡眠觉醒障碍的患者中，出现精神病症状的几率大约高出五倍。即使在没有整体认知障碍的患者中，PD 中的精神病也很常见，并且与其他非运动症状高度相关。作为广泛的非运动评估的一部分，应在 PD 的所有阶段对精神病进行筛查。此外，这些发现表明，PD 中感知、情绪、睡眠觉醒和认知能力下降的初始阶段紊乱存在共同的神经基础。
