1st Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece.
2nd Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
J Parkinsons Dis. 2023;13(7):1185-1197. doi: 10.3233/JPD-230056.
Some reports suggest that psychotic features may occur in the early stages of Parkinson's disease (PD), but sensitive tools have not been utilized.
The aim was to evaluate the presence of psychotic symptoms using detailed scales and to assess the association with clinical characteristics.
Healthy controls and patients within three years of PD onset were recruited. Participants were examined for psychotic symptoms using two different instruments: the Comprehensive Assessment of At-Risk Mental States (CAARMS) and a 10 question PD specific psychosis severity scale (10PDQ). In the PD group, medication use, motor and non-motor symptoms were documented.
Based on CAARMS and 10PDQ scales, psychotic features were present in 39% (27/70) of patients and 4% (3/74) of controls. The prevalence of passage hallucinations and illusions was significantly higher in PD compared to the control group. The presence of PD-associated psychotic features was not significantly affected by medication, motor severity or global cognitive status. Higher prevalence of overall non-motor manifestations, REM sleep behavior disorder (RBD) and depressive symptoms was significantly associated with the manifestation of psychotic features in PD [(adjusted OR:1.3; 95% CI:1.1-1.6; p = 0.003), (adjusted OR:1.3; 95% CI:1.0-1.6; p = 0.023), and (adjusted OR:1.2; 95% CI:1.0-1.4;p = 0.026)].
Psychotic phenomena mainly of minor nature are highly common in early PD. Cumulative non-motor symptoms, RBD and depressive features are associated with the presence of psychotic symptoms in this non-demented, early-stage PD population. More studies are needed to clarify the mechanisms that contribute to the onset of psychotic features in early PD.
一些报告表明，精神病特征可能出现在帕金森病（PD）的早期阶段，但尚未使用敏感工具。
旨在使用详细量表评估精神病症状的存在，并评估其与临床特征的相关性。
招募了健康对照者和 PD 发病三年内的患者。使用两种不同的工具评估参与者的精神病症状：全面评估高危精神状态量表（CAARMS）和 10 项 PD 特异性精神病严重程度量表（10PDQ）。在 PD 组中，记录了药物使用、运动和非运动症状。
根据 CAARMS 和 10PDQ 量表，39%（27/70）的患者和 4%（3/74）的对照组存在精神病特征。与对照组相比，PD 患者出现幻觉和错觉的患病率明显更高。PD 相关精神病特征的存在与药物、运动严重程度或整体认知状态无关。总体非运动表现、快速眼动睡眠行为障碍（RBD）和抑郁症状的更高患病率与 PD 中精神病特征的表现显著相关[调整后的 OR：1.3；95%CI：1.1-1.6；p=0.003]，（调整后的 OR：1.3；95%CI：1.0-1.6；p=0.023）和（调整后的 OR：1.2；95%CI：1.0-1.4；p=0.026）。
轻微性质的精神病现象在早期 PD 中非常常见。累积的非运动症状、RBD 和抑郁特征与该非痴呆、早期 PD 人群中精神病症状的存在相关。需要进一步研究以阐明导致早期 PD 中精神病特征发生的机制。
