Objective: The aim of this study was to compare clinical characteristics in Parkinson’s disease (PD) with psychosis (PDP) versus PD without psychosis (PDnP) and evaluate which clinical symptoms were predictive of the subsequent development of psychosis and Visual hallucinations (VH) .

Background: Psychosis and VH are a common and non-motor symptoms of PD and 20-40% PD patients present. Psychosis and VH seem to be associated with specific patterns of clinical symptoms and cognitive functions of PD.

Methods: 73 patients with diagnosis of PD in according to clinical criteria of the UKBBPD have been enrolled. The patients were assessed using Hoehn and Yahr stage (HY), Unified Parkinson’s disease Rating Scale (UPDRS) II and III parts, Mini Mental Status Examintaion (MMSE), de Boer’s quality of life (QOL) questionaire, and Modified Beck Depression Inventory (BDI). The PD patients with psychosis (PDP) and without psychosis (PDnP) were classified using cut-off 1 or higher score on item 2 of UPDRS I part.

Results: Total 73 patients: 29 male (39.7%) and 44 female (60.3%) patients were included. In 22 (30.2%) patients was diagnosed psychosis. 22 PDP (30.1%) patients (mean±SD age, 69.6±6.7 years) were matched with 51 PDnP (69,8%) patients (mean±SD age 65.7±11.0 years). Nonparametric Mann-Whitney test was done to elicit differences in baseline clinical characteristics among PDP vs PDnP patients. PDP patients had older aged (p<0.001), more advanced Hoehn and Yahr stage (HY) (p<0.001), more severe motor symptoms on UPDRS III (p<0.001), greater akinesia (p<0.001), rigidity (p<0.001), postural instability (p<0.001) subscore on UPDRS. Cognitive function on MMSE in PDP patients (21.7±5.1) was decreased than in PDnP (25.6±4.1) patients (p<0.001). QOL of PDP patients on Boer (p=0.008) and daily activity function on UPDRS II were lower than in PDnP patients. In contrast, there were no significant differences in age at onset (p=0.07), tremor subscore on UPDRS(p=0.2) and depressive disorder in BDI (p=0.4). When the predictors were entered into a linear stepwise regression analysis age at onset of disease, postural instability, rigidity, tremor symptoms, and cognitive impairment in PD patients (74.1% of the variables) could predict development of psychosis and VH (p<0.001).

Conclusions: Our results showed that old age, more severe motor symptoms, and cognitive impairment could be predictive of the subsequent development of psychosis and VH in PD patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/factors-related-to-psychotic-symptoms-in-patients-with-parkinsons-disease/