ArticleMovement disorders clinical practice
Onset and Remission of Psychosis in Parkinson's Disease: Pharmacologic and Motoric Markers.
Article in Movement disorders clinical practice. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed, 12 citations in OpenAlex.
- Case Files of the Emory University Medical Toxicology Fellowship: A Patient Presents to the Outpatient Toxicology Clinic with Delusions of Being Poisoned.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2024Article
- Lewy Body Degenerations as Neuropsychiatric Disorders.The Psychiatric clinics of North America · 2020Review
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Authors and funding
18 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundPsychosis is among the most disabling complications of Parkinson's disease (PD). The chronicity of PD psychosis remains understudied and the relative importance of dopaminergic therapy versus the disease process itself in engendering psychosis remains unclear.
objectivesTo examine pharmacologic and motoric correlates of PD psychosis onset and remission in a longitudinally monitored PD cohort.
methodsWe analyzed data from 165 participants enrolled in a longitudinal PD study through the Morris K. Udall Parkinson's Disease Research Center of Excellence at Johns Hopkins University. Evaluations included formal psychiatric assessment and were conducted at two-year intervals. Regression with generalized estimated equations (GEE) was used to produce unadjusted and adjusted estimates for time-varying longitudinal associations between psychosis and putative risk factors.
resultsSixty-two participants (37.6%) were diagnosed with psychosis during at least one evaluation. Of forty-nine participants with psychosis followed over multiple evaluations, 13 (26.5%) demonstrated remission despite significant Hoehn & Yahr stage increase (p=0.009); two of these cases later relapsed. Multivariable regression with GEE identified dementia diagnosis, akinesia-rigidity, anticholinergic usage, and levodopa-carbidopa dose to be significantly associated with psychosis, while disease duration was not. A sub-analysis of 30 incident psychosis cases suggested that dopamine agonist dose was lowered after psychosis onset with a compensatory increase in levodopa-carbidopa dosage.
conclusionsOur findings suggest that in the context of standard therapy, PD-related psychotic disorder can remit at a frequency of approximately 27%. Additionally, akinetic-rigid motor impairment was more strongly associated with psychosis than disease duration, independent of cognitive impairment and medications.
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