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Case Reports
. 2021 Jul;42(7):2721-2729.
doi: 10.1007/s10072-021-05249-4. Epub 2021 May 12.

Othello syndrome in Parkinson's disease: a systematic review and report of a case series

Giovanna De Michele  1 , Gianluigi Rosario Palmieri  1 , Chiara Pane  1 , Carmen Diletta Paola Dello Iacovo  1 , Sandra Perillo  1 , Francesco Saccà  1 , Giuseppe De Michele  1 , Anna De Rosa  2
Affiliations
Case Reports

Othello syndrome in Parkinson's disease: a systematic review and report of a case series

Giovanna De Michele et al. Neurol Sci. 2021 Jul.

Abstract

Introduction: Psychosis in Parkinson's disease (PD) is common and consists of hallucinations, illusions, and delusions. Among the latter, delusional jealousy, also named Othello syndrome (OS), might impair the quality of life of both patients and their partners. We aimed to perform a systematic review and report a series of PD patients presenting with OS.

Methods: A systematic review research was performed in PubMed database, excluding non-English articles, single case reports, reviews and neuropathology articles, comments, and articles concerning OS associated with deep brain stimulation (DBS) and levodopa-carbidopa intestinal gel infusion. We also described eleven PD patients (9 M and 2 F) with OS, identified in a cohort of consecutive 153 patients, comparing them with eleven matched no OS (nOS) PD subjects taken from the same cohort.

Results: We included eight articles (four case series and four cross-sectional studies). OS resulted more common among males than females. We did not find higher levodopa dose and levodopa equivalent dose for dopamine agonists and for all anti-parkinsonian drugs in our OS group. In our case series, OS patients showed visual hallucinations (p=0.001) and a trend to have depression (p=0.080) more frequently than nOS ones.

Conclusions: OS is not a rare disorder in PD, probably due not only to abnormal dopaminergic stimulation but also to serotonergic dysfunction in biologically predisposed subjects. Visual hallucinations and other concomitant psychiatric diseases, in particular depression, might represent a risk factor for the OS development.

Keywords: Delusional jealousy; Dopamine agonists; Othello syndrome; Parkinson’s disease; Psychosis; Visual hallucinations.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Diagram of the selection procedure to identify articles included in the systematic review
See this image and copyright information in PMC

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