Journal of Neurology

, Volume 259, Issue 1, pp 124–131 | Cite as

Psychiatric symptoms screening in the early stages of Parkinson’s disease

  • Paulo Bugalho
  • Joaquim Alves da Silva
  • Inês Cargaleiro
  • Madalena Serra
  • Bernardo Neto
Original Communication

Abstract

Psychiatric complaints are common in Parkinson’s disease (PD), and have a significant influence in disease outcome and quality of life. Little attention has been paid to psychiatric symptoms at early stage disease. We aimed to screen a population of early stage PD patients for psychiatric symptoms and to study the relation with motor and cognitive function. Thirty-six early stage PD patients underwent motor [Hoehn and Yahr (HY), Unified Parkinson’s Disease Rating Scale] and cognitive [Frontal Assessment Battery, Mini-Mental State Examination (MMSE)] assessment as well as general psychiatric [Symptom Check-List 90 (SCL-90-R)] and psychosis [Brief Psychiatric Rating Scale (BPRS)] screening. Relation between psychiatric domains scores was studied with principal component analysis. Relation between psychiatric, disease related, cognitive and motor function was assessed with bivariate correlation (Pearson). SCL-90-R scores were higher for somatization (significant scores in 66.7% of patients), depression (36.1%), anxiety (27%) and obsessive—compulsive symptoms (OCS) (52.8%). Scores were highly correlated, except for psychosis and phobia. Depression and anxiety were negatively correlated to MMSE score and dopaminergic doses, respectively. BPRS scores were higher for somatic concern, depression, anxiety and hallucinations. There was segregation between depression, anxiety, hallucinations, other positive psychotic symptoms and negative psychotic symptoms. Depression was related to MMSE score. We found a high prevalence of psychiatric complaints in PD patients, mostly related to depression, anxiety, somatization and OCS. Hallucinations were also frequent, but not associated to cognitive function or dopaminergic doses, suggesting a different physiopathological background.

Keywords

Parkinson’s disease Early stage Psychiatric symptoms Obsessive–compulsive symptoms Depression Psychosis Cognitive dysfunction 

Notes

Conflict of interest

None.

References

  1. 1.
    Aarsland D, Larsen JP, Cummins JL, Laake K (1999) Prevalence and clinical correlates of psychotic symptoms in Parkinson disease: a community-based study. Arch Neurol 56(5):595–601PubMedCrossRefGoogle Scholar
  2. 2.
    Aarsland D, Larsen JP, Lim NG et al (1999) Range of neuropsychiatric disturbances in patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry 67(4):492–496PubMedCrossRefGoogle Scholar
  3. 3.
    Aarsland D, Brønnick K, Alves G et al (2009) The spectrum of neuropsychiatric symptoms in patients with early untreated Parkinson’s disease. J Neurol Neurosurg Psychiatry 80(8):928–930PubMedCrossRefGoogle Scholar
  4. 4.
    Alegret M, Junqué C, Valldeoriola F, Vendrell P, Martí MJ, Tolosa E (2001) Obsessive-compulsive symptoms in Parkinson’s disease. J Neurol Neurosurg Psychiatry 70(3):394–396PubMedCrossRefGoogle Scholar
  5. 5.
    American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorder, 4th ed edn. APA, WashingtonGoogle Scholar
  6. 6.
    Braak H, Del Tredici K, Rüb U, de Vos RA, Jansen Steur EN, Braak E (2003) Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging 24(2):197–211PubMedCrossRefGoogle Scholar
  7. 7.
    Derogatis LR (1977) Symptom check list-90 revised. Administration scoring and procedures manual. Clinical Psychometrics Unit, Johns Hopkins University, BaltimoreGoogle Scholar
  8. 8.
    Dissanayaka NN, Sellbach A, Matheson S, O’Sullivan JD, Silburn PA, Byrne GJ, Marsh R, Mellick GD (2010) Anxiety disorders in Parkinson’s disease: prevalence and risk factors. Mov Disord 25(7):838–845PubMedCrossRefGoogle Scholar
  9. 9.
    Dubois B, Slachevsky A, Litvan I, Pillon B (2000) The FAB: a frontal assessment battery at bedside. Neurology 55:1621–1626PubMedGoogle Scholar
  10. 10.
    Dubois B, Burn D, Goetz C et al (2007) Diagnostic procedures for Parkinson’s disease dementia: recommendations from the Movement Disorder Society Task Force. Mov Disord 22(16):2314–2324PubMedCrossRefGoogle Scholar
  11. 11.
    Fahn S, Elton RL, and members of the UPDRS Development Committee (1987) Unified Parkinson’s Disease Rating Scale. In: Fahn S, Marsden CD, Calne DB, Goldstein M (eds) Recent Developments in Parkinson’s Disease. Macmollan Health Care Information, Florham Park, pp 153–163, 293–304Google Scholar
  12. 12.
    Fénelon G, Mahieux F, Huon R, Ziégler M (2000) Hallucinations in Parkinson’s disease: prevalence, phenomenology and risk factors. Brain 123(Pt 4):733–745PubMedCrossRefGoogle Scholar
  13. 13.
    Fernandez HH, Aarsland D, Fénelon G, Friedman JH, Marsh L, Tröster AI et al (2008) Scales to assess psychosis in Parkinson’s disease: critique and recommendations. Mov Disord 23(4):484–500PubMedCrossRefGoogle Scholar
  14. 14.
    Folstein M, Folstein S, McHugh P (1975) Mini-mental state a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198PubMedCrossRefGoogle Scholar
  15. 15.
    Friedman A (1994) Old-onset Parkinson’s disease compared with young-onset disease: clinical differences and similarities. Acta Neurol Scand 89(4):258–261PubMedCrossRefGoogle Scholar
  16. 16.
    Gelb DJ, Oliver E, Gilman S (1999) Diagnostic criteria for Parkinson’s disease. Arch Neurol 56:33–39PubMedCrossRefGoogle Scholar
  17. 17.
    Graham JM, Grünewald RA, Sagar HJ (1997) Hallucinosis in idiopathic Parkinson’s disease. J Neurol Neurosurg Psychiatry 63(4):434–440PubMedCrossRefGoogle Scholar
  18. 18.
    Harbishettar V, Pal PK, Janardhan Reddy YC, Thennarasu K (2005) Is there a relationship between Parkinson’s disease and obsessive-compulsive disorder? Parkinsonism Relat Disord 11(2):85–88PubMedCrossRefGoogle Scholar
  19. 19.
    Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression and mortality. Neurology 17:427–442PubMedGoogle Scholar
  20. 20.
    Jankovic J, McDermott M, Carter J et al (1990) Variable expression of Parkinson’s disease: a base-line analysis of the DATATOP cohort. Neurology 40(10):1529–1534PubMedGoogle Scholar
  21. 21.
    Kenangil G, Orken DN, Ur E, Forta H (2010) Frontal assessment battery in patients with Parkinson disease in a Turkish population. Cogn Behav Neurol 23(1):26–28PubMedCrossRefGoogle Scholar
  22. 22.
    Kostić VS, Agosta F, Petrović I et al (2010) Regional patterns of brain tissue loss associated with depression in Parkinson disease. Neurology 75(10):857–863PubMedCrossRefGoogle Scholar
  23. 23.
    Kulisevsky J, Pagonabarraga J, Pascual-Sedano B, García-Sánchez C, Gironell A, Trapecio Group Study (2008) Prevalence and correlates of neuropsychiatric symptoms in Parkinson’s disease without dementia. Mov Disord 23(13):1889–1896PubMedCrossRefGoogle Scholar
  24. 24.
    Maia AF, Pinto AS, Barbosa ER, Menezes PR, Miguel EC (2003) Obsessive compulsive symptoms, obsessive-compulsive disorder, and related disorders in Parkinson’s disease. J Neuropsychiatry Clin Neurosci 15(3):371–374PubMedCrossRefGoogle Scholar
  25. 25.
    McGuire PK (1995) The brain in obsessive-compulsive disorder. J Neurol Neurosurg Psychiatry 59:457–459PubMedCrossRefGoogle Scholar
  26. 26.
    McKinlay A, Grace RC, Dalrymple-Alford JC, Anderson T, Fink J, Roger D (2008) A profile of neuropsychiatric problems and their relationship to quality of life for Parkinson’s disease patients without dementia. Parkinsonism Relat Disord 14(1):37–42PubMedCrossRefGoogle Scholar
  27. 27.
    Nègre-Pagès L, Grandjean H, Lapeyre-Mestre M, Montastruc JL, Fourrier A, Lépine JP, Rascol O, DoPaMiP Study Group (2010) Anxious and depressive symptoms in Parkinson’s disease: the French cross-sectionnal DoPaMiP study. Mov Disord 25(2):157–166PubMedCrossRefGoogle Scholar
  28. 28.
    Onofrj M, Bonanni L, Manzoli L, Thomas A (2010) Cohort study on somatoform disorders in Parkinson disease and dementia with Lewy bodies. Neurology 74(20):1598–1606PubMedCrossRefGoogle Scholar
  29. 29.
    Overall JE, Gorham DR (1988) The Brief Psychiatric Rating Scale (BPRS): recent developments in ascertainment and scaling. Psychopharmacol Bull 24:97–99Google Scholar
  30. 30.
    Parkin SG, Gregory RP, Scott R et al (2002) Unilateral and bilateral pallidotomy for idiopathic Parkinson’s disease: a case series of 115. Mov Disord 17:682–692PubMedCrossRefGoogle Scholar
  31. 31.
    Pontone GM, Williams JR, Anderson KE et al (2009) Prevalence of anxiety disorders and anxiety subtypes in patients with Parkinson’s disease. Mov Disord 24(9):1333–1338PubMedCrossRefGoogle Scholar
  32. 32.
    Sanchez-Ramos JR, Ortoll R, Paulson GW (1996) Visual hallucinations associated with Parkinson disease. Arch Neurol 53(12):1265–1268PubMedCrossRefGoogle Scholar
  33. 33.
    Schiffer RB, Kurlan R, Rubin A, Boer S (1988) Evidence for atypical depression in Parkinson’s disease. Am J Psychiatry 145(8):1020–1022PubMedGoogle Scholar
  34. 34.
    Siri C, Cilia R, De Gaspari D et al (2010) Psychiatric symptoms in Parkinson’s disease assessed with the SCL-90R self-reported questionnaire. Neurol Sci 31(1):35–40PubMedCrossRefGoogle Scholar
  35. 35.
    Takagi R, Kajimoto Y, Kamiyoshi S, Miwa H, Kondo T (2002) The frontal assessment battery at bedside (FAB) in patients with Parkinson’s disease. No To Shinkei 54(10):897–902PubMedGoogle Scholar
  36. 36.
    Tandberg E, Larsen JP, Aarsland D, Cummings JL (1996) The occurrence of depression in Parkinson’s disease. A community-based study. Arch Neurol 53(2):175–179PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Paulo Bugalho
    • 1
    • 2
  • Joaquim Alves da Silva
    • 3
    • 4
  • Inês Cargaleiro
    • 3
  • Madalena Serra
    • 3
  • Bernardo Neto
    • 3
  1. 1.Neurology DepartmentHospital de Egas Moniz (CHLO)LisbonPortugal
  2. 2.Neurology DepartmentFaculdade de Ciências Médicas de LisboaLisbonPortugal
  3. 3.Psychiatry DepartmentHospital de S. Francisco Xavier (CHLO)LisbonPortugal
  4. 4.Psychiatry DepartmentFaculdade de Ciências Médicas de LisboaLisbonPortugal

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