title: Neuropsychiatric symptoms in Serbian patients with Parkinson's disease.
abstract: BACKGROUND
  Parkinson's disease [PD] is associated with wide variety of neuropsychiatric symptoms, although it is primarily considered as a movement disorder.
  
  
  OBJECTIVE
  To examine whether PD patients can be meaningfully classified into subgroups according to their neuropsychiatric symptoms, reported by their caregivers.
  
  
  METHODS
  Three hundred and sixty PD patients [mean age=63.5, SD=10.3] from the academic clinical setting were assessed with the 12-subscale Neuropsychiatric Inventory Questionnaire [NPI]. A two-stage cluster analysis was used to identify the subgroups groups of patients with specific neuropsychiatric profile.
  
  
  RESULTS
  Three hundred and twenty-one PD patients [89%] showed at least one psychiatric symptom. The most common symptoms were anxiety [73.1%], depression [64.7%], and apathy [51.7%], and nighttime disturbance [51.3%], whereas the least common were euphoria [0.3%], and delusions [1.7%]. The mean [SD] total NPI composite score was 16.9 [17.4]. Two hundred eight PD subjects [58%] of the total sample had at least one symptom with a score ≥4. Three clusters were identified: a] Cluster 1, with no or few NPI symptoms [n=200; 55.6%]; b] Cluster 2, with mild to moderate symptoms on depression, anxiety and apathy scales [n=140; 38.9%]; and c] Cluster 3 with high agitation, disinhibition and irritability scores [n=20 patients; 5.6%]. PD subjects with clinically significant neuropsychiatric symptoms were older with more severe motor and cognitive impairment.
  
  
  CONCLUSIONS
  This study emphasizes the high prevalence and importance of neuropsychiatric symptoms in PD patients; therefore clinicians should also focus on treating in parallel with motor symptoms.
authors.affiliation: Clinic of Neurology, Clinical Center Kragujevac, Serbia.
authors.forename: Mirjana
authors.initials: M
authors.lastname: Petrovic
authors.affiliation: Faculty of Medicine, University of Belgrade, Serbia; Clinic of Neurology, CCS, Serbia.
authors.forename: Elka
authors.initials: E
authors.lastname: Stefanova
authors.affiliation: Faculty of Philology, University of Belgrade, Serbia.
authors.forename: Ljubomir
authors.initials: L
authors.lastname: Ziropadja
authors.affiliation: Faculty of Medicine, University of Belgrade, Serbia; Clinic of Neurology, CCS, Serbia.
authors.forename: Tanja
authors.initials: T
authors.lastname: Stojkovic
authors.affiliation: Faculty of Medicine, University of Belgrade, Serbia; Clinic of Neurology, CCS, Serbia. Electronic address: vladimir.s.kostic@gmail.com.
authors.forename: Vladimir S
authors.initials: VS
authors.lastname: Kostic
mesh_terms: D000046:Academic Medical Centers; D016000:Cluster Analysis; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D015995:Prevalence; D055771:Serbia; D012720:Severity of Illness Index
keywords: Caregiver; Cluster analysis; Neuropsychiatric inventory