January 2012
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; on
behalf of the PRIAMO Study Group
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.
