The clinical characteristics and related factors of psychosis in patients with Parkinson's disease
10.3760/cma.j.issn.0254-9026.2013.03.012
- VernacularTitle:已治疗帕金森病患者的精神病性障碍特点及相关因素分析
- Author:
Qi LIU
;
Wen SU
;
Haibo CHEN
- Publication Type:Journal Article
- Keywords:
Parkinson disease;
Mental disorders;
Hallucinations
- From:
Chinese Journal of Geriatrics
2013;(3):282-285
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the clinical features and related factors of psychosis in patients with Parkinson's disease (PD) and assess the prevalence of psychosis.Methods A total of 82 patients with Parkinson's disease and 69 healthy controls were evaluated by Brief Psychiatric Rating Scale and neuropsychiatric questionnaire.For the PD group,the age at PD onset,type and dose of PD medications,and rapid eye movement (REM) sleep behavior disorder (RBD) were recorded.Unified Parkinson's disease rating scale (UPDRS,parts Ⅱ and Ⅲ) and Hoehn-Yahr staging were used for the evaluation of the severity of motor dysfunction,Hamilton depression scale (HAMD) for emotional state,montreal cognitive assessment (MoCA) for cognition,and scales for outcomes in Parkinson's disease-SLEEP (SCOPA-SLEEP) for quality of sleep.Results The prevalence of psychosis was 36.59％ in PD patients and 2.90％ in the control group.The difference between the two groups was statistically significant (P＜ 0.001).Among the 30 PD patients with PD psychosis meeting the NINDS/NIMH criteria,patients experienced illusions,false sense of presence,hallucinations and delusions was 22.0％,14.6％,29.3％,and 7.3％,respectively.Univariate analysis showed that age,levodopa equivalent dosage,SCOPA-SLEEP scores,and prevalence of RBD were significantly higher in thePDP group [(71.1±6.18),(628.7±283.2),(15.3±7.28),60.00％] than in the PDNP group [(66.6±9.25),(461.1±317.2),(9.7±7.64),28.85％] (all P＜0.05).Multivariate analysis showed that Hoehn-Yahr staging was a protective factor (OR =0.039,95％ CI:0.004-0.402),while sleep disorder was a risk factor (OR=1.157,95％CI:1.015-1.320).The PD patients with more psychotic symptoms were much older and with higher SCOPA-SLEEP scores,which had a statistically significant difference (P =0.0042,P =0.0112).Conclusions The prevalence of psychosis is much higher in PD patients than in healthy controls.PD psychosis is correlated with older age,larger levodopa equivalent doses,higher SCOPA-SLEEP scores,and prevalence of REM sleep behavior disorder.
