Management of Psychosis in Parkinson’s Disease: Emphasizing Clinical Subtypes and Pathophysiological Mechanisms of the Condition

Table 1

Studies on the prevalence of psychotic symptoms in PD.

Study		Setting/design	Assessment instruments	Main findings
Celesia et al., 1970	45	Outpatient/prospective longitudinal	Columbia disability scale	17.7% developed psychosis (delusions, hallucinations, behavioral disorder)
Sweet et al., 1976	100	Outpatient/retrospective	Cornell, weighted scale, WAIS	60% agitated confusion
Moskovitz et al., 1978	88	Outpatient/retrospective	No	48% experienced vivid dreams (30.7%), hallucinations (29.5%), illusions (5.7%), and nonconfusional (9.1%), confusional psychoses (3.4%)
de Smet et al., 1982	75	Inpatient/retrospective	No	31% confusional states
Tanner et al., 1983	775	Outpatient/retrospective	HY	33% hallucinations
Fischer et al., 1990	25	Inpatient/retrospective	HY, MMSE	80% at least one episode of “pharmacotoxic psychosis”
Sanchez-Ramos et al., 1996	214	Outpatient/prospective cross-sectional	HY, MMSE	25.7% visual hallucinations
Inzelberg et al., 1998	121	Outpatient/prospective cross-sectional	HY, SMT	29% visual, 8% visual and auditory hallucinations
Aarsland et al., 1999	245	Community/prospective cross-sectional	UPDRS, MMSE, DSM-III-R, MADRAS	25.5% vivid dreaming, 9.8% hallucinations with insight retained, and 6% severe hallucinations or delusions
Fenelon et al., 2000	216	Outpatient/prospective cross-sectional	UPDRS, HY, MMP, CES-D, DSM-IV	39.8% hallucinations. Minor hallucinations 25.5%, formed visual hallucinations 22.2%, and auditory hallucinations 9.7%
Giladi et al., 2000	172	Outpatient/prospective cross-sectional	HY, MMSE, DSM-IV, ADAS-cog	27% had psychosis
Goetz et al., 2001	60	Outpatient/prospective longitudinal	UPDRS, HY, RHI	Hallucinations increased from 33% at baseline to 44% at 18 months and 63% at 48 months
Holroyd et al., 2001	102	Outpatient/prospective cross-sectional	DSM-IV, TICS, GDS	29.4% had hallucinations or delusions
Doe De Maindreville, 2004		Outpatient/prospective longitudinal	UPDRS, HY, MMP, CES-D, DSM-IV	Hallucinations increased from 41.7% to 49.6% over 12 months

HY: Hoehn and Yahr staging; SMT: Short Mental Test; MMSE: Mini Mental State Examination; UPDRS: Unified PD Rating Scale; MMP: Mini Mental Parkinson; DSM-III-R: Diagnostic and Statistical Manual for Psychiatric Disorders, revised third edition; DSM-IV: Diagnostic and Statistical Manual of Mental Disorders, 4th edition; MADRAS: Montgomery and Asberg Depression Rating Scale; RHI: Rush Hallucination Inventory; ADAS-cog: Alzheimer’s Disease Assessment Scale (ADAS) Cognitive Section; TICS: Telephone Interview for Cognitive Status; GDS: Geriatric Depression Scale; WAIS: Wechsler Adult Intelligence Scale; CES-D: Center for Epidemiologic Studies-Depression self-rating scale; reference: Papapetropoulos and Mash, 2005 [31].