Screening, Diagnosis, and Management of Parkinson’s Disease Psychosis: Recommendations From an Expert Panel

Abstract

Abstract Introduction Hallucinations and delusions present with psychosis are debilitating non-motor symptoms of Parkinson’s disease, with a prevalence of up to 50–70% at some point during the course of the disease. Often patients and caregivers do not report the presence of hallucinations or delusions unless specifically questioned. A panel of experts in neurology and geriatric psychiatry convened to develop a simple screening tool and guidance on diagnosis and treatment of Parkinson’s disease psychosis (PDP). Methods The working group reviewed literature for existing PDP guidelines on diagnosis and management and identified gaps in recommendations. The group discussed and developed a screening tool and treatment guidance that addressed the gaps in existing methodology based on their clinical experience. Results The proposed screening tool consists of two parts: (1) a brief pre-visit screening portion to be completed by the patient and caregiver, and (2) a clinician portion to be completed via clinical interview of the patient and caregiver. If psychotic symptoms are present, an appropriate treatment plan is developed for PDP based on evaluation. Conclusions This simple screening tool and treatment guidance offers a practical clinical approach for clinicians in the diagnosis and management of PDP.

Keywords

• Antipsychotics
• Delusions
• Hallucinations
• Parkinson’s disease
• Parkinson’s disease psychosis
• Pimavanserin