title: Diagnosis, assessment and management of delusional jealousy in Parkinson's disease with and without dementia.
abstract: Patients with Parkinson's disease (PD) may present delusional jealousy (DJ). In a previous cross-sectional prevalence study we identified 15 cognitively preserved and five demented PD patients with DJ. The current study aimed at evaluating their clinical (motor and non-motor) characteristics and the pharmacological treatments associated with DJ, and its subsequent pharmacological management. Patients were assessed by neurologists and psychiatrists using the Hoehn and Yahr scale, the Unified Parkinson's Disease Rating Scale, the Brief Psychiatric Rating Scale, the Beck Depression Inventory, the Hamilton Anxiety Scale and the Neuropsychiatric Inventory. Efficacy of DJ management was evaluated in follow-up visits. All patients were in therapy with dopamine agonists. A subgroup of five cognitively preserved patients developed DJ after a short period of treatment of therapy with dopamine agonists, while other patients developed DJ after a longer period of dopaminergic treatment. Psychiatric comorbidities were common in cognitively preserved and in demented patients. The pharmacological management included the interruption of dopamine agonists in two patients and the reduction of dopamine agonist dose plus the use of antipsychotics in other patients. These clinical data suggest that the management of medicated PD patients should include investigation for the presence of DJ and the evaluation of clinical characteristics potentially relevant to the prevention or the early recognition of delusions.
authors.affiliation: Department of Psychiatry, University of Pisa, Pisa, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Perugi
authors.forename: Michele
authors.initials: M
authors.lastname: Poletti
authors.forename: Chiara
authors.initials: C
authors.lastname: Logi
authors.forename: Caterina
authors.initials: C
authors.lastname: Berti
authors.forename: Anna
authors.initials: A
authors.lastname: Romano
authors.forename: Paolo
authors.initials: P
authors.lastname: Del Dotto
authors.forename: Claudio
authors.initials: C
authors.lastname: Lucetti
authors.forename: Roberto
authors.initials: R
authors.lastname: Ceravolo
authors.forename: Liliana
authors.initials: L
authors.lastname: Dell'Osso
authors.forename: Ubaldo
authors.initials: U
authors.lastname: Bonuccelli
mesh_terms: D000368:Aged; D018491:Dopamine Agonists / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007578:Jealousy; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012563:Schizophrenia, Paranoid / Q000175:diagnosis* / Q000209:etiology
chemical_list: D018491:Dopamine Agonists