Distribution and correlation of psychiatric symptoms in early stages of parkinson’s disease

Abstract

The premotor phase of Parkinson Disease (PD) precedes the classical motor phase and the clinical picture is dominated by nonmotor symptoms. The psychiatric symptoms, an important category of nonmotors symptoms, need to be evaluated and treated. The study objective was to assess the frequency of nonmotor symptoms in patients with PD in early stages of the disease and to establish correlations between these symptoms and the features of disease or clinical characteristics of patients. The group of patients enrolled in the study included a number of 43 patients with early PD, enrolled during a period of one year in Neurology Clinic I, from Cluj-Napoca, Romania. For all patients enrolled in the study, the questionnaire NMS-PD QUEST was applied. Psychiatric complaints play an important role as there were no patients who did not present at least one psychiatric symptom and in most cases patients have described a complex of associated symptoms: roughly one third of the patients of both genders complain about 5 symptoms of each of this type, simultaneneously. Within the psychiatric field, the most prevalent symptoms belonged to affective disorders-depression-81,39%, followed by disorders of attention and concentration-79, 06%. Regarding the correlations monitored in the study, the analysis of parameters show that the only statistically significant correlation was with family history of PD. The field of sleep disorders was well represented by insomnia, present in 69.76% of cases, which was followed by excessive daytime sleepiness and sleep with nightmares in equal percentages of 46.51%. The most common psychiatric symptoms reported by the questionnaire even from the early stages were depression, attention and memory problems and those related to impaired sleep. The results presented highlights the importance of questioning the patients about nonmotor complaints from the very beginning of the diagnostic process.