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Review
. 2018 Nov 1;33(47):e300.
doi: 10.3346/jkms.2018.33.e300. eCollection 2018 Nov 19.

Psychiatric Manifestation in Patients with Parkinson's Disease

Ji Won Han  1 , Yebin D Ahn  1 , Won-Seok Kim  2 , Cheol Min Shin  3 , Seong Jin Jeong  4 , Yoo Sung Song  5 , Yun Jung Bae  6 , Jong-Min Kim  7
Affiliations
Review

Psychiatric Manifestation in Patients with Parkinson's Disease

Ji Won Han et al. J Korean Med Sci. .

Abstract

Parkinson's disease (PD) is the second most common neurodegenerative disorder. Although its major manifestation is motor symptoms, resulting from the loss of dopaminergic neurons in the substantia nigra, psychiatric symptoms, such as depression, anxiety, hallucination, delusion, apathy and anhedonia, impulsive and compulsive behaviors, and cognitive dysfunction, may also manifest in most patients with PD. Given that the quality of life - and the need for institutionalization - is so highly dependent on the psychiatric well-being of patients with PD, psychiatric symptoms are of high clinical significance. We reviewed the prevalence, risk factors, pathophysiology, and treatment of psychiatric symptoms to get a better understanding of PD for improved management.

Keywords: Dementia; Depression; Impulse Control Disorder; Parkinson's Disease; Psychiatry; Psychosis.

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Conflict of interest statement

Disclosure: The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Diagram of psychiatric manifestations in PD. Nonmotor symptoms in PD include various psychiatric symptoms, such as depression, anxiety, psychosis, apathy/anhedonia, ICD, and dementia. These psychiatric symptoms contribute to impaired quality of life for patients and families and are considered risk factors for nursing home placement.
PD = Parkinson's disease, ICD = impulse control disorder, DLBD = diffuse Lewy body disease, PDD = Parkinson's disease dementia.
Fig. 2
Fig. 2. Diagnostic nomenclature of depression in PD. The Diagnostic and Statistical Manual of Mental Disorders (5th Edition) by American Psychiatric Association classifies depression according to its etiology and symptom severity. The provisional diagnostic criteria for depression in Parkinson's disease proposed by the NINDS/NIMH Work Group classifies depression according to the presence or absence of symptoms and severity.
PD = Parkinson's disease, DSM-IV-TR = a text revision of diagnostic and statistical manual of mental disorders (4th edition), DSM-5 = diagnostic and statistical manual of mental disorders (5th edition).
See this image and copyright information in PMC

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