Objective: To evaluate a structured clinical interview (SCI) based on the Parkinson’s disease-specific Scale for the Assessment of Positive Symptoms (SAPS-PD) in the identification of delusions and olfactory, tactile, gustatory, and minor hallucinations in PD psychosis (PD-P).

Background: Most PD-P rating scales focus on visual hallucinations (VHs), auditory hallucinations, and specific delusions, but not other psychotic symptoms.

Methods: Cross-sectional analysis of 150 outpatients with PD (40% female; ages 67.0+9.7 years).  Median disease duration was 81 months (range 3-301), modified Hoehn and Yahr was 2 (range 1-5), UPDRS motor score was 22 (range 3-73), and MoCA was 26 (range 16-30).  Subjects participated in an SCI that included the SAPS-PD with additional prompts for delusions and olfactory, tactile, gustatory, and minor hallucinations.  Symptoms detected by this SCI were compared with those identified by standard clinical assessments.

Results: Our SCI detected psychotic symptoms in 45 subjects (30%).  Hallucinations were present in 43 subjects (29%); most commonly VHs (n=37, 25%), followed by olfactory (n=8, 5%), auditory (n=3, 2%), tactile (n=3, 2%), and gustatory hallucinations (n=1, 1%).  Well-formed major VHs were reported by 7 (5%), and minor VHs by 36 (24%); these included passage hallucinations (n=29), illusions (n=17), and presence hallucinations (n=10).  Delusions were endorsed by 12 subjects (8%), and were mostly persecutory (n=8).  Overall, our SCI had much greater sensitivity for detection of psychotic symptoms than the SAPS-PD alone (42%), clinic visit (36%), Non-Motor Symptoms Questionnaire (27%), or UPDRS part 1 (20%).  While the clinic visit identified 86% of major visual hallucinations, it missed 100% of tactile and gustatory hallucinations, 92% of delusions, 75% of olfactory hallucinations, and 72% of minor VHs.

Conclusions: The prevalence of delusions and olfactory, tactile, gustatory, and minor hallucinations is markedly underestimated by standard measures.  Our SCI more than doubled the number of identified psychotic symptoms compared with other clinical assessments.

« Back to 2017 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/systematic-evaluation-of-major-and-minor-psychotic-symptoms-in-parkinsons-disease/