Department of Psychiatry, Ringgold: 29148National Institute of Mental Health and Neurosciences, Bangalore, India.
Department of Neurology, National Institute of Mental Health & Neurosciences, Bangalore, India.
J Geriatr Psychiatry Neurol. 2023 Mar;36(2):155-163. doi: 10.1177/08919887221103575. Epub 2022 May 17.
Psychiatric comorbidity in Parkinson's disease (PD) and atypical parkinsonian syndromes (APS) has been consistently associated with poor outcomes. However, the co-occurrence of multiple psychiatric disorders has been sparsely studied. This study examines the prevalence, patterns, and correlates of psychiatric comorbidity and multimorbidity among in-patients hospitalised with PD/APS.
Patients (N-110 [PD-71, APS-39]) underwent a single cross-sectional assessment. Psychiatric comorbidity was examined using the Mini International Neuropsychiatric Interview. Other domains assessed include sleep disorders, quality of life, and caregiver burden.
In addition to descriptive statistics, multinomial logistic regression was used to examine the effect of sociodemographic and clinical factors on comorbidities.
The prevalence of psychiatric comorbidity in patients with PD and APS was 77.00% and 71.79%, with approximately half of those having co-occurrence of multiple psychiatric disorders. In both disorders, depression was the most common, followed by anxiety disorder. The two commonest patterns of multimorbidity reported in PD were the combination of depression and anxiety disorder, followed by the combination of psychosis, depression, and anxiety, with the order being reversed in APS. When compared to those without, those with single psychiatric comorbidity had higher odds of having REM sleep behaviour disorder and caregiver stress. Those with multiple psychiatric comorbidities had higher odds of being female, higher UPDRS part-1 scores, REM sleep behaviour disorder, poor sleep quality, and caregiver stress.
Psychiatric illness is highly comorbid among patients with PD/APS, with most having multiple co-occurring psychiatric illnesses. Clinicians must be aware to ensure early detection and intervention.
帕金森病（PD）和非典型帕金森综合征（APS）患者的精神共病一直与不良结局相关。然而，多种精神障碍的共发情况研究较少。本研究旨在调查 PD/APS 住院患者精神共病和共患多种精神障碍的患病率、模式和相关因素。
患者（N=110[PD-71，APS-39]）接受了单次横断面评估。使用 Mini 国际神经精神访谈（MINI）检查精神共病。评估的其他领域包括睡眠障碍、生活质量和照顾者负担。
除了描述性统计外，还使用多项逻辑回归分析检查社会人口学和临床因素对共病的影响。
PD 和 APS 患者的精神共病患病率分别为 77.00%和 71.79%，其中约一半患者存在多种精神障碍共发。在这两种疾病中，最常见的是抑郁症，其次是焦虑症。报告的 PD 中最常见的两种共病模式是抑郁症和焦虑症同时存在，其次是精神病、抑郁症和焦虑症同时存在，而在 APS 中则相反。与无共病者相比，单种精神共病患者发生 REM 睡眠行为障碍和照顾者压力的可能性更高。而多种精神共病患者更有可能为女性，UPDRS 第一部分评分更高，存在 REM 睡眠行为障碍、睡眠质量差和照顾者压力。
PD/APS 患者的精神疾病高度共病，大多数患者存在多种共患的精神疾病。临床医生必须意识到这一点，以确保早期发现和干预。
