title: Psychosis associated to Parkinson's disease in the early stages: relevance of cognitive decline and depression.
abstract: 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.
authors.affiliation: Dipartimento di Neuroscienze, Scienze Psichiatriche ed Anestesiologiche, Università di Messina, Via Consolare Valeria 1, 98125 Messina, Italy. morgante@unime.it
authors.forename: Letterio
authors.initials: L
authors.lastname: Morgante
authors.forename: Carlo
authors.initials: C
authors.lastname: Colosimo
authors.forename: Angelo
authors.initials: A
authors.lastname: Antonini
authors.forename: Roberto
authors.initials: R
authors.lastname: Marconi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Meco
authors.forename: Massimo
authors.initials: M
authors.lastname: Pederzoli
authors.forename: Francesco E
authors.initials: FE
authors.lastname: Pontieri
authors.forename: Giulio
authors.initials: G
authors.lastname: Cicarelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Abbruzzese
authors.forename: Salvatore
authors.initials: S
authors.lastname: Zappulla
authors.forename: Silvia
authors.initials: S
authors.lastname: Ramat
authors.forename: Michela
authors.initials: M
authors.lastname: Manfredi
authors.forename: Edo
authors.initials: E
authors.lastname: Bottacchi
authors.forename: Michele
authors.initials: M
authors.lastname: Abrignani
authors.forename: Alfredo
authors.initials: A
authors.lastname: Berardelli
authors.forename: Autilia
authors.initials: A
authors.lastname: Cozzolino
authors.forename: Claudio
authors.initials: C
authors.lastname: Paradiso
authors.forename: Danilo
authors.initials: D
authors.lastname: De Gaspari
authors.forename: Francesca
authors.initials: F
authors.lastname: Morgante
authors.forename: Paolo
authors.initials: P
authors.lastname: Barone
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D003071:Cognition; D003863:Depression / Q000209:etiology* / Q000523:psychology; D005260:Female; D006212:Hallucinations / Q000209:etiology / Q000523:psychology; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000523:psychology*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D012307:Risk Factors; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric