Psychiatric aspects of Parkinson's disease

Abstract

In Parkinson's disease failure to respond to treatment or to benefit from rehabilitation when symptoms are well controlled may be due to a dementing process with personality changes and a decline in cognitive functions. The presence of affective disturbance, especially depression, may lead to an increase in disability and distress: antidepressant treatment added to the most effective antiparkinsonian treatment may lead to an overall improvement. The presence of depressive symptoms may be obscured by other features of the condition. Many of the treatments available for Parkinson's disease may produce a variety of psychiatric symptoms and signs. These are particularly frequent and severe in the case of L dopa. The results of investigations of the mental effects of Parkinson's disease do not suggest a simple relationship between the depletion of dopamine in the brain stem and the occurrence of affective symptoms, as the psychiatric complications of the condition and its treatment are so varied and persistent.