期刊
NEUROLOGY
卷 63, 期 2, 页码 293-300出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/01.WNL.0000129843.15756.A3
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资金
- NCRR NIH HHS [M01-RR00052] Funding Source: Medline
- NINDS NIH HHS [P50-NS-58377] Funding Source: Medline
Objective: To determine the prevalence and impact of comorbid psychiatric disturbances in Parkinson disease (PD) patients with psychosis. Methods: Subject data were derived from a research database of 116 PD patients participating in standardized motor, cognitive, psychiatric, and caregiver assessments. Results: There were 25 patients (22%) with psychosis manifest as hallucinations (n = 9), delusions ( n = 1), or hallucinations and delusions ( n = 15) and 25 patients ( 22%) who had no current or past psychiatric comorbidities (PDN). In the psychotic group, 44% had psychosis only (PSY), and 56% had psychosis plus at least one other comorbid psychiatric disturbance ( PSY+), including depressive disorders (71%), anxiety disorders (21%), apathetic syndromes (14%), and delirium ( 14%). There were no differences in age, sex, education, or age onset or duration of PD among the PSY, PSY+, and PDN groups. Both psychotic groups had greater motor, functional, and frontal cognitive deficits and increased caregiver burden scores relative to PDN. PSY+ showed greater global and selective cognitive deficits compared to PDN. Psychosis was a primary predictor of caregiver burden, whereas depressive symptoms indirectly enhanced motor impairments. Conclusions: Nonpsychotic psychiatric disturbances, especially affective disturbances, are common comorbidities in PD patients with psychosis and warrant clinical attention to reduce morbidity and caregiver distress.
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