Neurological Sciences

, Volume 34, Issue 9, pp 1537–1541 | Cite as

Diagnosis, assessment and management of delusional jealousy in Parkinson’s disease with and without dementia

  • Giulio Perugi
  • Michele Poletti
  • Chiara Logi
  • Caterina Berti
  • Anna Romano
  • Paolo Del Dotto
  • Claudio Lucetti
  • Roberto Ceravolo
  • Liliana Dell’Osso
  • Ubaldo Bonuccelli
Original Article

Abstract

Patients with Parkinson’s disease (PD) may present delusional jealousy (DJ). In a previous cross-sectional prevalence study we identified 15 cognitively preserved and five demented PD patients with DJ. The current study aimed at evaluating their clinical (motor and non-motor) characteristics and the pharmacological treatments associated with DJ, and its subsequent pharmacological management. Patients were assessed by neurologists and psychiatrists using the Hoehn and Yahr scale, the Unified Parkinson’s Disease Rating Scale, the Brief Psychiatric Rating Scale, the Beck Depression Inventory, the Hamilton Anxiety Scale and the Neuropsychiatric Inventory. Efficacy of DJ management was evaluated in follow-up visits. All patients were in therapy with dopamine agonists. A subgroup of five cognitively preserved patients developed DJ after a short period of treatment of therapy with dopamine agonists, while other patients developed DJ after a longer period of dopaminergic treatment. Psychiatric comorbidities were common in cognitively preserved and in demented patients. The pharmacological management included the interruption of dopamine agonists in two patients and the reduction of dopamine agonist dose plus the use of antipsychotics in other patients. These clinical data suggest that the management of medicated PD patients should include investigation for the presence of DJ and the evaluation of clinical characteristics potentially relevant to the prevention or the early recognition of delusions.

Keywords

Parkinson’s disease Delusional jealousy Dementia Dopamine agonists Levodopa Psychosis 

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Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • Giulio Perugi
    • 1
  • Michele Poletti
    • 2
  • Chiara Logi
    • 3
  • Caterina Berti
    • 3
  • Anna Romano
    • 1
  • Paolo Del Dotto
    • 3
  • Claudio Lucetti
    • 3
  • Roberto Ceravolo
    • 2
  • Liliana Dell’Osso
    • 1
  • Ubaldo Bonuccelli
    • 2
  1. 1.Department of PsychiatryUniversity of PisaPisaItaly
  2. 2.Department of NeuroscienceUniversity of PisaPisaItaly
  3. 3.Department of Neurology UnitHospital of ViareggioToscanaItaly

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