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Psychiatric symptoms in Parkinson’s disease

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Abstract

Parkinson’s disease (PD) is a neurodegenerative disorder which is often reduced to a mere dysfunction of motor performance. Non-motor symptoms, however, are frequent impairments in PD and result in a major impact on the patients and their caregivers. The major neuropsychiatric comorbidities depression, anxiety, and psychotic symptoms are briefly discussed. Additionally, a brief outlook on deep brain stimulation and its effect on psychiatric symptoms is provided. Several studies did show that neuropsychiatric symptoms are underdiagnosed and consecutively treated inadequately. All in all more attention should be directed to the detection and treatment of psychiatric symptoms in PD patients in routine clinical settings.

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References

  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 56:595–601

    Article  PubMed  CAS  Google Scholar 

  2. Althaus A, Arranz Becker O, Spottke A, Dengler R, Schneider F, Kloss M, Eggert K, Oertel WH, Dillmann U, Herting B, Classen J, Dodel R (2008) Frequency and treatment of depressive symptoms in a Parkinson’s disease registry. Parkinsonism Relat Disord

  3. Brown R, Jahanshahi M (1995) Depression in Parkinson’s disease: a psychosocial viewpoint. Adv Neurol 65:61–84

    PubMed  CAS  Google Scholar 

  4. Burn DJ (2002) Beyond the iron mask: towards better recognition and treatment of depression associated with Parkinson’s disease. Mov Disord 17:445–454

    Article  PubMed  Google Scholar 

  5. Castelli L, Perozzo P, Zibetti M, Crivelli B, Morabito U, Lanotte M, Cossa F, Bergamasco B, Lopiano L (2006) Chronic deep brain stimulation of the subthalamic nucleus for Parkinson’s disease: effects on cognition, mood, anxiety and personality traits. Eur Neurol 55:136–144

    Article  PubMed  CAS  Google Scholar 

  6. Chen JJ (2004) Anxiety, depression, and psychosis in Parkinson’s disease: unmet needs and treatment challenges. Neurol Clin 22:S63–S90

    Article  PubMed  Google Scholar 

  7. Deuschl G, Schade-Brittinger C, Krack P, Volkmann J, Schafer H, Botzel K, Daniels C, Deutschlander A, Dillmann U, Eisner W, Gruber D, Hamel W, Herzog J, Hilker R, Klebe S, Kloss M, Koy J, Krause M, Kupsch A, Lorenz D, Lorenzl S, Mehdorn HM, Moringlane JR, Oertel W, Pinsker MO, Reichmann H, Reuss A, Schneider GH, Schnitzler A, Steude U, Sturm V, Timmermann L, Tronnier V, Trottenberg T, Wojtecki L, Wolf E, Poewe W, Voges J (2006) A randomized trial of deep-brain stimulation for Parkinson’s disease. N Engl J Med 355:896–908

    Article  PubMed  CAS  Google Scholar 

  8. Ehmann TS, Beninger RJ, Gawel MJ, Riopelle RJ (1990) Depressive symptoms in Parkinson’s disease: a comparison with disabled control subjects. J Geriatr Psychiatry Neurol 3:3–9

    Article  PubMed  CAS  Google Scholar 

  9. Fenelon G, Goetz CG, Karenberg A (2006) Hallucinations in Parkinson disease in the prelevodopa era. Neurology 66:93–98

    Article  PubMed  Google Scholar 

  10. Fenelon G, Mahieux F, Huon R, Ziegler M (2000) Hallucinations in Parkinson’s disease: prevalence, phenomenology and risk factors. Brain 123(Pt 4):733–745

    Article  PubMed  Google Scholar 

  11. Fernandez HH, Aarsland D, Fenelon G, Friedman JH, Marsh L, Troster AI, Poewe W, Rascol O, Sampaio C, Stebbins GT, Goetz CG (2008) Scales to assess psychosis in Parkinson’s disease: critique and recommendations. Mov Disord 23:484–500

    Article  PubMed  Google Scholar 

  12. Fernandez HH, Trieschmann ME, Burke MA, Jacques C, Friedman JH (2003) Long-term outcome of quetiapine use for psychosis among Parkinsonian patients. Mov Disord 18:510–514

    Article  PubMed  Google Scholar 

  13. Frieling H, Hillemacher T, Ziegenbein M, Neundorfer B, Bleich S (2007) Treating dopamimetic psychosis in Parkinson’s disease: structured review and meta-analysis. Eur Neuropsychopharmacol 17:165–171

    Article  PubMed  CAS  Google Scholar 

  14. Ghazi-Noori S, Chung TH, Deane KHO, Rickards H, Clarke CE (2007) Therapies for depression in Parkinson’s disease (Review) Cochrane Database of Systematic Reviews 2003

  15. Jimenez-Jimenez FJ, Tejeiro J, Martinez-Junquera G, Cabrera-Valdivia F, Alarcon J, Garcia-Albea E (1994) Parkinsonism exacerbated by paroxetine. Neurology 44:2406

    PubMed  CAS  Google Scholar 

  16. Kerenyi L, Ricaurte GA, Schretlen DJ, McCann U, Varga J, Mathews WB, Ravert HT, Dannals RF, Hilton J, Wong DF, Szabo Z (2003) Positron emission tomography of striatal serotonin transporters in Parkinson disease. Arch Neurol 60:1223–1229

    Article  PubMed  Google Scholar 

  17. Kim SE, Choi JY, Choe YS, Choi Y, Lee WY (2003) Serotonin transporters in the midbrain of Parkinson’s disease patients: a study with 123I-beta-CIT SPECT. J Nucl Med 44:870–876

    PubMed  CAS  Google Scholar 

  18. Krack P, Batir A, Van Blercom N, Chabardes S, Fraix V, Ardouin C, Koudsie A, Limousin PD, Benazzouz A, LeBas JF, Benabid AL, Pollak P (2003) Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N Engl J Med 349:1925–1934

    Article  PubMed  CAS  Google Scholar 

  19. Leentjens A, Van den Akker M, Metsemakers J, Lousberg R, Verhey F (2003) Higher incidence of depression preceding the onset of Parkinson’s disease: a register study. Mov Disord 18:414–418

    Article  PubMed  Google Scholar 

  20. Marsh L, McDonald WM, Cummings J, Ravina B (2006) Provisional diagnostic criteria for depression in Parkinson’s disease: report of an NINDS/NIMH Work Group. Mov Disord 21:148–158

    Article  PubMed  Google Scholar 

  21. Marsh L, Williams JR, Rocco M, Grill S, Munro C, Dawson TM (2004) Psychiatric comorbidities in patients with Parkinson disease and psychosis. Neurology 63:293–300

    PubMed  CAS  Google Scholar 

  22. Nuti A, Ceravolo R, Piccinni A, Dell’Agnello G, Bellini G, Gambaccini G, Rossi C, Logi C, Dell’Osso L, Bonuccelli U (2004) Psychiatric comorbidity in a population of Parkinson’s disease patients. Eur J Neurol 11:315–320

    Article  PubMed  CAS  Google Scholar 

  23. Oertel WH, Hoglinger GU, Caraceni T, Girotti F, Eichhorn T, Spottke AE, Krieg JC, Poewe W (2001) Depression in Parkinson’s disease. An update. Adv Neurol 86:373–383

    PubMed  CAS  Google Scholar 

  24. Reijnders JS, Ehrt U, Weber WE, Aarsland D, Leentjens AF (2008) A systematic review of prevalence studies of depression in Parkinson’s disease. Mov Disord 23:183–189 quiz 313

    Article  PubMed  Google Scholar 

  25. Riedel O, Klotsche J, Spottke A, Deuschl G, Förstl H, Henn F, Heuser I, Oertel W, Reichmann H, Riederer P, Trenkwalder C, Dodel R, Wittchen HU (2008) Cognitive impairment in 873 patients with idiopathic Parkinson's disease. Results from the German Study on Epidemiology of Parkinson's Disease with Dementia (GEPAD). J Neurol 255(2):255–264

    Google Scholar 

  26. Rojo A, Aguilar M, Garolera MT, Cubo E, Navas I, Quintana S (2003) Depression in Parkinson’s disease: clinical correlates and outcome. Parkinsonism Relat Disord 10:23–28

    Article  PubMed  CAS  Google Scholar 

  27. Schneider F, Habel U, Volkmann J, Regel S, Kornischka J, Sturm V, Freund HJ (2003) Deep brain stimulation of the subthalamic nucleus enhances emotional processing in Parkinson disease. Arch Gen Psychiatry 60:296–302

    Article  PubMed  Google Scholar 

  28. Schuurman A, van den Akker M, Ensinck K, Metsemakers J, Knottnerus J, Leentjens A, Buntinx F (2002) Increased risk of Parkinson’s disease after depression: a retrospective cohort study. Neurology 58:1501–1504

    PubMed  CAS  Google Scholar 

  29. Shabnam GN, Th C, Kho D, H R, Ce C (2003) Therapies for depression in Parkinson’s disease. Cochrane Database Syst Rev: CD003465

  30. Starkstein SE, Merello M, Jorge R, Brockman S, Bruce D, Petracca G, Robinson RG (2008) A validation study of depressive syndromes in Parkinson’s disease. Mov Disord 23:538–546

    Article  PubMed  Google Scholar 

  31. Stein MB, Heuser IJ, Juncos JL, Uhde TW (1990) Anxiety disorders in patients with Parkinson’s disease. Am J Psychiatry 147:217–220

    PubMed  CAS  Google Scholar 

  32. Takeshita S, Kurisu K, Trop L, Arita K, Akimitsu T, Verhoeff NP (2005) Effect of subthalamic stimulation on mood state in Parkinson’s disease: evaluation of previous facts and problems. Neurosurg Rev 28:179–186 discussion 187

    Article  PubMed  Google Scholar 

  33. Vazquez A, Jimenez-Jimenez FJ, Garcia-Ruiz P, Garcia-Urra D (1993) “Panic attacks” in Parkinson’s disease. A long-term complication of levodopa therapy. Acta Neurol Scand 87:14–18

    Article  PubMed  CAS  Google Scholar 

  34. Veazey C, Aki SO, Cook KF, Lai EC, Kunik ME (2005) Prevalence and treatment of depression in Parkinson’s disease. J Neuropsychiatry Clin Neurosci 17:310–323

    PubMed  Google Scholar 

  35. von Campenhausen S, Bornschein B, Wick R, Botzel K, Sampaio C, Poewe W, Oertel W, Siebert U, Berger K, Dodel R (2005) Prevalence and incidence of Parkinson’s disease in Europe. Eur Neuropsychopharmacol 4:473–490

    Article  CAS  Google Scholar 

  36. Walsh K, Bennett G (2001) Parkinson’s disease and anxiety. Postgrad Med J 77:89–93

    Article  PubMed  CAS  Google Scholar 

  37. Weintraub D, Hurtig HI (2007) Presentation and management of psychosis in Parkinson’s disease and dementia with Lewy bodies. Am J Psychiatry 164:1491–1498

    Article  PubMed  Google Scholar 

  38. Weintraub D, Morales KH, Moberg PJ, Bilker WB, Balderston C, Duda JE, Katz IR, Stern MB (2005) Antidepressant studies in Parkinson’s disease: a review and meta-analysis. Mov Disord 20:1161–1169

    Article  PubMed  Google Scholar 

  39. Weisskopf MG, Chen H, Schwarzschild MA, Kawachi I, Ascherio A (2003) Prospective study of phobic anxiety and risk of Parkinson’s disease. Mov Disord 18:646–651

    Article  PubMed  Google Scholar 

  40. Wint DP, Okun MS, Fernandez HH (2004) Psychosis in Parkinson’s disease. J Geriatr Psychiatry Neurol 17:127–136

    Article  PubMed  Google Scholar 

  41. Wolters EC (1999) Dopaminomimetic psychosis in Parkinson’s disease patients: diagnosis and treatment. Neurology 52:S10–S13

    PubMed  CAS  Google Scholar 

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Conflict of interest statement

F. Schneider received grants/ research support from AstraZeneca and from Lundbeck in the recent years and is consultant for AstraZeneca, Otsuka and Janssen-Cilag. A. Althaus, V. Backes and R. Dodel have no financial conflicts of interests to declare.

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Authors and Affiliations

  1. Dept. of Psychiatry and Psychotherapy, RWTH Aachen , Pauwelsstraße 30, 52074, Aachen, Germany

    Frank Schneider MD, PhD, Astrid Althaus MA & Volker Backes MA

  2. JARA, Translational Brain Medicine, Dept. of Psychiatry and Psychotherapy, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany

    Frank Schneider MD, PhD & Volker Backes MA

  3. Institute for Research in Operative Medicine (IFOM), University of Witten-Herdecke, Witten, Germany

    Astrid Althaus MA

  4. Dept. of Neurology, Philipps-University Marburg, Marburg, Germany

    Richard Dodel MD

Authors
  1. Frank Schneider MD, PhD
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  2. Astrid Althaus MA
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  3. Volker Backes MA
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  4. Richard Dodel MD
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Correspondence to Frank Schneider MD, PhD.

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Schneider, F., Althaus, A., Backes, V. et al. Psychiatric symptoms in Parkinson’s disease. Eur Arch Psychiatry Clin Neurosci 258 (Suppl 5), 55–59 (2008). https://doi.org/10.1007/s00406-008-5012-4

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  • DOI: https://doi.org/10.1007/s00406-008-5012-4

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