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Psychiatric disorders in Parkinson’s

Psychiatric disorders are one of the most common and disabling non-motor symptoms of Parkinson’s. As such, these psychiatric disorders should be recognized and treated accordingly. For further details, please refer to the “Mental” complications in the “Medical Facts” section of this website. In the present section, the videos of two Parkinson’s who suffered from psychiatric disorders are presented.

Video-1-Depression

The video of the Parkinson’s patient (who chose to remain anonymous) with depression highlights the strong relationship between depression and Parkinson’s. Depression can occur at any stage of the illness, especially right after diagnosis of Parkinson’s or during the advanced stage of illness when the physical disability is severe. However, depression can also precede the motor symptoms of Parkinson’s by a few years, as illustrated by the present video. In this case, depression has been thought to be the early symptoms of Parkinson’s or even risk factor for developing Parkinson’s.

Video-2-Psychosis (Part 1 and Part 2)

The video of the Ms. Ebby Loo, caregiver of Parkinson’s patient, provides a very clear illustration of psychosis in Parkinson’s. Her 74-year-old father, Mr. Loo, had four attacks of psychosis over a period of seven years before he eventually became demented. Psychosis refers to an abnormal mental state that is characterized by delusion, confusion and hallucination.

Delusion is an abnormal thought process that is characterized by a strong belief which is firmly held despite indisputable evidence to the contrary (i.e. false belief). Delusion of persecution or paranoid delusion refers to false belief that one is being harmed or persecuted by others. Mr. Loo was worried about “intruders” in his home (paranoid delusion). In order to “improve the home security”, Mr. Loo had dismantled all the padlocks in the house and asked his son to replace them.

Mr. Loo also had another type of paranoid delusion, which was pathological jealousy, a condition in which Parkinson’s patients suspect their spouses are having extra-marital affair and even sexual relationship with others. Mr. Loo accused his wife of having “affair”.

A prominent feature of psychosis in Parkinson’s is hallucination, which refers to false perception of non-existent sensory stimulus. A common type of hallucination is visual hallucination (seeing things which are not there). In Mr. Loo’s case, he saw many “dwarfs” who intruded into his home.