Psychosis associated to Parkinson's disease in the early stages: Relevance of cognitive decline and depression

Letterio Morgante, Carlo Colosimo, Angelo Antonini, Roberto Marconi, Giuseppe Meco, Massimo Pederzoli, Francesco E. Pontieri, Giulio Cicarelli, Giovanni Abbruzzese, Salvatore Zappulla, Silvia Ramat, Michela Manfredi, Edo Bottacchi, Michele Abrignani, Alfredo Berardelli, Autilia Cozzolino, Claudio Paradiso, Danilo De Gaspari, Francesca Morgante, Paolo Barone

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate the prevalence of psychosis associated with Parkinson's disease (PSY-PD) in its early stages, its incidence over a 24 month follow-up period and the association with motor and non-motor clinical features. Methods: PRIAMO is a 2 year longitudinal observational study that has enrolled patients with parkinsonism in 55 Italian centres. A cohort of 495 patients with early disease stage PD (baseline Hoehn and Yahr score ≤2, disease's duration (median) 3.4 years) were followed for 2 years. PSY-PD was evaluated by means of a clinician rated questionnaire and defined as the presence of at least one of the following symptoms occurring for at least 1 month: illusions, hallucinations, jealousy ideas and persecutory ideas. Patients with and without PSY-PD were compared on several clinical variables, encompassing motor and non-motor features. Results: The prevalence of PSY-PD at baseline was 3%; the incidences at 12 and 24 months were 5.2% and 7.7%, respectively. Longer disease duration and prescription of dopamine agonists at baseline were associated with the development of PSY-PD over the 24 month period. At this follow-up time, worse disease severity, decline in cognitive performances, presence of depressive symptoms and anxiety were more frequently observed in PSY-PD. Conclusions: Psychotic type symptoms may occur in the early stages of PD although less frequently than in later stages. Beyond dopaminergic treatment, there are disease related factors, such as disease severity and the occurrence of cognitive and depressive symptoms, which may underlie the onset of psychotic type symptoms from the earliest stages.

Original languageEnglish
Pages (from-to)76-82
Number of pages7
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume83
Issue number1
DOIs
Publication statusPublished - Jan 2012

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Psychotic Disorders
Parkinson Disease
Depression
Jealousy
Neurobehavioral Manifestations
Hallucinations
Incidence
Dopamine Agonists
Parkinsonian Disorders
Observational Studies
Prescriptions
Longitudinal Studies
Cognitive Dysfunction
Parkinson's Disease
Psychosis
Anxiety
Depressive Symptoms

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Surgery
  • Arts and Humanities (miscellaneous)

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Psychosis associated to Parkinson's disease in the early stages : Relevance of cognitive decline and depression. / Morgante, Letterio; Colosimo, Carlo; Antonini, Angelo; Marconi, Roberto; Meco, Giuseppe; Pederzoli, Massimo; Pontieri, Francesco E.; Cicarelli, Giulio; Abbruzzese, Giovanni; Zappulla, Salvatore; Ramat, Silvia; Manfredi, Michela; Bottacchi, Edo; Abrignani, Michele; Berardelli, Alfredo; Cozzolino, Autilia; Paradiso, Claudio; De Gaspari, Danilo; Morgante, Francesca; Barone, Paolo.

In: Journal of Neurology, Neurosurgery and Psychiatry, Vol. 83, No. 1, 01.2012, p. 76-82.

Research output: Contribution to journalArticle

Morgante, L, Colosimo, C, Antonini, A, Marconi, R, Meco, G, Pederzoli, M, Pontieri, FE, Cicarelli, G, Abbruzzese, G, Zappulla, S, Ramat, S, Manfredi, M, Bottacchi, E, Abrignani, M, Berardelli, A, Cozzolino, A, Paradiso, C, De Gaspari, D, Morgante, F & Barone, P 2012, 'Psychosis associated to Parkinson's disease in the early stages: Relevance of cognitive decline and depression', Journal of Neurology, Neurosurgery and Psychiatry, vol. 83, no. 1, pp. 76-82. https://doi.org/10.1136/jnnp-2011-300043
Morgante, Letterio ; Colosimo, Carlo ; Antonini, Angelo ; Marconi, Roberto ; Meco, Giuseppe ; Pederzoli, Massimo ; Pontieri, Francesco E. ; Cicarelli, Giulio ; Abbruzzese, Giovanni ; Zappulla, Salvatore ; Ramat, Silvia ; Manfredi, Michela ; Bottacchi, Edo ; Abrignani, Michele ; Berardelli, Alfredo ; Cozzolino, Autilia ; Paradiso, Claudio ; De Gaspari, Danilo ; Morgante, Francesca ; Barone, Paolo. / Psychosis associated to Parkinson's disease in the early stages : Relevance of cognitive decline and depression. In: Journal of Neurology, Neurosurgery and Psychiatry. 2012 ; Vol. 83, No. 1. pp. 76-82.
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AU - Morgante, Letterio

AU - Colosimo, Carlo

AU - Antonini, Angelo

AU - Marconi, Roberto

AU - Meco, Giuseppe

AU - Pederzoli, Massimo

AU - Pontieri, Francesco E.

AU - Cicarelli, Giulio

AU - Abbruzzese, Giovanni

AU - Zappulla, Salvatore

AU - Ramat, Silvia

AU - Manfredi, Michela

AU - Bottacchi, Edo

AU - Abrignani, Michele

AU - Berardelli, Alfredo

AU - Cozzolino, Autilia

AU - Paradiso, Claudio

AU - De Gaspari, Danilo

AU - Morgante, Francesca

AU - Barone, Paolo

PY - 2012/1

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N2 - Objective: To evaluate the prevalence of psychosis associated with Parkinson's disease (PSY-PD) in its early stages, its incidence over a 24 month follow-up period and the association with motor and non-motor clinical features. Methods: PRIAMO is a 2 year longitudinal observational study that has enrolled patients with parkinsonism in 55 Italian centres. A cohort of 495 patients with early disease stage PD (baseline Hoehn and Yahr score ≤2, disease's duration (median) 3.4 years) were followed for 2 years. PSY-PD was evaluated by means of a clinician rated questionnaire and defined as the presence of at least one of the following symptoms occurring for at least 1 month: illusions, hallucinations, jealousy ideas and persecutory ideas. Patients with and without PSY-PD were compared on several clinical variables, encompassing motor and non-motor features. Results: The prevalence of PSY-PD at baseline was 3%; the incidences at 12 and 24 months were 5.2% and 7.7%, respectively. Longer disease duration and prescription of dopamine agonists at baseline were associated with the development of PSY-PD over the 24 month period. At this follow-up time, worse disease severity, decline in cognitive performances, presence of depressive symptoms and anxiety were more frequently observed in PSY-PD. Conclusions: Psychotic type symptoms may occur in the early stages of PD although less frequently than in later stages. Beyond dopaminergic treatment, there are disease related factors, such as disease severity and the occurrence of cognitive and depressive symptoms, which may underlie the onset of psychotic type symptoms from the earliest stages.

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