1
|
Bowers P, Rosenkrantz B, Palanci J, Goldsmith D, Cotes R. A Slow, Cautious, and Successful Clozapine Rechallenge After Myocarditis. Prim Care Companion CNS Disord 2022; 24. [DOI: 10.4088/pcc.21cr02976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
2
|
Dhingra A, Janjua AU, Hack L, Waserstein G, Palanci J, Hermida AP. Exploring Nonmotor Neuropsychiatric Manifestations of Parkinson Disease in a Comprehensive Care Setting. J Geriatr Psychiatry Neurol 2021; 34:181-195. [PMID: 32242493 DOI: 10.1177/0891988720915525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Parkinson disease (PD) is a debilitating neurological condition that includes both motor symptoms and nonmotor symptoms (NMS). Psychiatric complaints comprise NMS and are collectively referred to as neuropsychiatric manifestations. Common findings include atypical depressive symptoms, anxiety, psychosis, impulse control disorder, deterioration of cognition, and sleep disturbances. Quality of life (QoL) of patients suffering from NMS is greatly impacted and many times can be more debilitating than motor symptoms of PD. We expand on knowledge gained from treatment models within a comprehensive care model that incorporates multidisciplinary specialists working alongside psychiatrists to treat PD. Insight into background, clinical presentations, and treatment options for patients suffering from neuropsychiatric manifestations of PD are discussed. Identifying symptoms early can help improve QoL, provide early symptom relief, and can assist tailoring treatment plans that limit neuropsychiatric manifestations.
Collapse
Affiliation(s)
- Amitha Dhingra
- Department of Psychiatry and Behavioral Sciences, 12239Emory University School of Medicine, Atlanta, GA, USA
| | - A Umair Janjua
- Department of Psychiatry and Behavioral Sciences, 12239Emory University School of Medicine, Atlanta, GA, USA
| | - Laura Hack
- Department of Psychiatry and Behavioral Sciences, 12239Emory University School of Medicine, Atlanta, GA, USA
| | - Gabriella Waserstein
- Department of Psychiatry and Behavioral Sciences, 12239Emory University School of Medicine, Atlanta, GA, USA
| | - Justin Palanci
- Department of Psychiatry and Behavioral Sciences, 12239Emory University School of Medicine, Atlanta, GA, USA
| | - Adriana P Hermida
- Department of Psychiatry and Behavioral Sciences, 12239Emory University School of Medicine, Atlanta, GA, USA
| |
Collapse
|
3
|
Affiliation(s)
- Cindy Peterson-Dana
- Peer and Recovery Support Services, Mental Health Association, Westchester, New York (Peterson-Dana); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Palanci)
| | - Justin Palanci
- Peer and Recovery Support Services, Mental Health Association, Westchester, New York (Peterson-Dana); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Palanci)
| |
Collapse
|
4
|
Pontone GM, Williams JR, Anderson KE, Chase G, Goldstein SR, Grill S, Hirsch ES, Lehmann S, Little JT, Margolis RL, Palanci J, Rabins PV, Weiss HD, Marsh L. Pharmacologic treatment of anxiety disorders in Parkinson disease. Am J Geriatr Psychiatry 2013; 21:520-8. [PMID: 23567419 PMCID: PMC3655116 DOI: 10.1016/j.jagp.2012.10.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 09/27/2012] [Accepted: 10/12/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Neither best practices nor an evidence base for the pharmacologic treatment of anxiety in Parkinson disease (PD) has been established. This study investigated pharmacologic treatment of anxiety disorders in idiopathic PD and the associated clinical features. DESIGN Cross-sectional. SETTING Three community-based movement disorder neurology practices. PARTICIPANTS 250 subjects with PD. MEASUREMENTS Anxiety disorder diagnoses were established by consensus using a panel of six psychiatrists with expertise in geriatric psychiatry and movement disorders. Current medications were provided by the treating neurologists at the time of interview. RESULTS Among subjects with anxiety disorders only, 53% were untreated with medications. When anxious subjects with comorbid depressive disorders were included, 70.8% were on medications effective for treatment of anxiety. Subjects with anxiety and comorbid depressive disorders were more likely to be treated for their psychiatric disturbances than subjects with anxiety disorders alone (odds ratio: 8.33), as were subjects with comorbid motor fluctuations (odds ratio: 3.65). There were no differences in the types of anti-anxiety medications used in regard to the presence of depression or motor fluctuations. CONCLUSIONS These findings suggest that over half of nondepressed PD patients with clinically significant anxiety are untreated with medication. A better understanding of the role of clinical features associated with anxiety in PD, such as depression and motor fluctuations, may improve the recognition and treatment of anxiety disorders in this population.
Collapse
Affiliation(s)
- Gregory M Pontone
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Pontone GM, Palanci J, Williams JR, Bassett SS. Screening for DSM-IV-TR cognitive disorder NOS in Parkinson's disease using the Mattis Dementia Rating Scale. Int J Geriatr Psychiatry 2013; 28:364-71. [PMID: 22628158 PMCID: PMC3449223 DOI: 10.1002/gps.3833] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 04/24/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study explores the utility of the Mattis Dementia Rating Scale (MDRS) as a screening tool for the Diagnostic and Statistical Manual for Mental Disorders 4th edition (DSM-IV-TR) diagnosis cognitive disorder not otherwise specified (NOS) in Parkinson's disease (PD). METHODS A total of 125 individuals with PD were diagnosed using DSM-IV-TR criteria for cognitive disorder NOS and dementia. Receiver operating characteristics (ROC) tested the discriminant validity of the MDRS, with the clinician's diagnosis serving as the gold standard. RESULTS The MDRS ROC curve to discriminate subjects with cognitive disorder NOS from non-demented subjects had an area under the curve of 0.59 (standard error = 0.08, 95% CI: 0.43-0.74). CONCLUSIONS The MDRS is not effective for identifying PD patients with cognitive disorder NOS without dementia.
Collapse
Affiliation(s)
- Gregory M. Pontone
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD,Morris K. Udall Parkinson’s Disease Research Center of Excellence at Johns Hopkins,Correspondence to: Greg Pontone, MD, Johns Hopkins University School of Medicine, 600 N. Wolfe Street - Phipps 300, Baltimore, MD 21287, , o:(410) 502-0477/f:(410)614-3676
| | - Justin Palanci
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD,Morris K. Udall Parkinson’s Disease Research Center of Excellence at Johns Hopkins
| | - James R. Williams
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD,Biogen Idec, Cambridge, MA
| | - Susan Spear Bassett
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD,Morris K. Udall Parkinson’s Disease Research Center of Excellence at Johns Hopkins
| |
Collapse
|
6
|
Calleo J, Williams JR, Amspoker AB, Swearingen L, Hirsch ES, Anderson K, Goldstein SR, Grill S, Lehmann S, Little JT, Margolis RL, Palanci J, Pontone GM, Weiss H, Rabins P, Marsh L. Application of Depression Rating Scales in Patients with Parkinson's Disease with and without Co-Occurring Anxiety. Journal of Parkinson's Disease 2013; 3:603-8. [DOI: 10.3233/jpd-130264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Jessica Calleo
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX, USA
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
| | - James R. Williams
- Biogen Idec, Cambridge, MA, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Amber B. Amspoker
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX, USA
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
| | - Leah Swearingen
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Karen Anderson
- University of Maryland Medical Center, Baltimore, MD, USA
| | - Susanne R. Goldstein
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- US Food and Drug Administration, Silver Spring, MD, USA
- Parkinson's and Movement Disorder Center of Maryland, Elkridge, MD, USA
| | - Stephen Grill
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Parkinson's and Movement Disorder Center of Maryland, Elkridge, MD, USA
| | - Susan Lehmann
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - John T. Little
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Georgetown University Medical Center, Washington, DC, USA
- Veteran's Affairs Medical Center, Washington, DC, USA
| | | | - Justin Palanci
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Howard Weiss
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter Rabins
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Laura Marsh
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
7
|
Williams JR, Hirsch ES, Anderson K, Bush AL, Goldstein SR, Grill S, Lehmann S, Little JT, Margolis RL, Palanci J, Pontone G, Weiss H, Rabins P, Marsh L. A comparison of nine scales to detect depression in Parkinson disease: which scale to use? Neurology 2012; 78:998-1006. [PMID: 22422897 DOI: 10.1212/wnl.0b013e31824d587f] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The Methods of Optimal Depression Detection in Parkinson's Disease (MOOD-PD) study compared the psychometric properties of 9 depression scales to provide guidance on scale selection in Parkinson disease (PD). METHODS Patients with PD (n = 229) from community-based neurology practices completed 6 self-report scales (Beck Depression Inventory [BDI]-II, Center for Epidemiologic Studies Depression Rating Scale-Revised [CESD-R], 30-item Geriatric Depression Scale [GDS-30], Inventory of Depressive Symptoms-Patient [IDS-SR], Patient Health Questionnaire-9 [PHQ-9], and Unified Parkinson's Disease Rating Scale [UPDRS]-Part I) and were administered 3 clinician-rated scales (17-item Hamilton Depression Rating Scale [HAM-D-17], Inventory of Depressive Symptoms-Clinician [IDS-C], and Montgomery-Åsberg Depression Rating Scale [MADRS] and a psychiatric interview. DSM-IV-TR diagnoses were established by an expert panel blinded to the self-reported rating scale data. Receiver operating characteristic curves were used to estimate the area under the curve (AUC) of each scale. RESULTS All scales performed better than chance (AUC 0.75-0.85). Sensitivity ranged from 0.66 to 0.85 and specificity ranged from 0.60 to 0.88. The UPDRS Depression item had a smaller AUC than the BDI-II, HAM-D-17, IDS-C, and MADRS. The CESD-R also had a smaller AUC than the MADRS. The remaining AUCs were statistically similar. CONCLUSIONS The GDS-30 may be the most efficient depression screening scale to use in PD because of its brevity, favorable psychometric properties, and lack of copyright protection. However, all scales studied, except for the UPDRS Depression, are valid screening tools when PD-specific cutoff scores are used.
Collapse
Affiliation(s)
- J R Williams
- Food and Drug Administration, Silver Spring, MD, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Mack J, Rabins P, Anderson K, Goldstein S, Grill S, Hirsch ES, Lehmann S, Little JT, Margolis RL, Palanci J, Pontone G, Weiss H, Williams JR, Marsh L. Prevalence of psychotic symptoms in a community-based Parkinson disease sample. Am J Geriatr Psychiatry 2012; 20:123-32. [PMID: 21617521 PMCID: PMC3168582 DOI: 10.1097/jgp.0b013e31821f1b41] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES : To determine the prevalence of psychotic phenomena, including minor symptoms, in a Parkinson disease (PD) sample and compare the clinical correlates associated with the various psychotic phenomena. To evaluate the extent to which cases met National Institute of Neurological Diseases and Stroke (NINDS)/National Institute of Mental Health (NIMH)-proposed criteria for PD-associated psychosis. METHODS : A total of 250 patients with idiopathic PD and Mini Mental State Exam scores greater than 23 from three community-based movement disorder clinics underwent comprehensive research diagnostic evaluations by a geriatric psychiatrist as part of a study on mood disorders in PD. Psychotic symptoms were categorized using a checklist, which included a breakdown of hallucinations, delusions, and minor symptoms. Clinical characteristics of groups with minor and other psychotic symptoms were compared. The NINDS/NIMH criteria for PD-psychosis were retrospectively applied. RESULTS : Of the total sample, 26% of patients were found to have any current psychotic symptoms, with 47.7% of those having isolated minor symptoms, and 52.3% having hallucinations and/or delusions. Compared to those with no current psychiatric symptoms, minor symptoms were associated with more depressive symptoms and worse quality of life, and 90.8% of those with psychotic symptoms fulfilled the NINDS/NIMH proposed criteria. CONCLUSIONS : Psychotic symptoms are common in PD patients, with minor psychotic phenomena present in nearly half of affected patients in a community-based sample. Psychotic symptoms, including minor phenomena, were clinically significant. The NINDS/NIMH PD-psychosis criteria captured the clinical characteristics of psychosis as it relates to PD. Longitudinal studies are needed to determine whether minor psychotic symptoms represent a precursor to hallucinations and delusions, and to further validate diagnostic criteria.
Collapse
Affiliation(s)
- Joel Mack
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter Rabins
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Karen Anderson
- University of Maryland Medical Center, Baltimore, MD, USA
| | - Susanne Goldstein
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Parkinson's and Movement Disorder Center of Maryland, Baltimore, MD, USA
| | - Stephen Grill
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Parkinson's and Movement Disorder Center of Maryland, Baltimore, MD, USA
| | | | - Susan Lehmann
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - John T. Little
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Justin Palanci
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gregory Pontone
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Howard Weiss
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Laura Marsh
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
9
|
Pontone GM, Palanci J, Bienvenu OJ, Liang KY, Nestadt G, Rabins PV, Williams JR, Marsh L. Familial aggregation of panic disturbances in Parkinson's disease. J Neuropsychiatry Clin Neurosci 2011; 23:417-24. [PMID: 22231313 PMCID: PMC3547673 DOI: 10.1176/jnp.23.4.jnp417] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Panic disorder has an elevated prevalence in Parkinson's disease (PD). To explore the basis for this co-occurrence, the familial aggregation of panic disorder was examined in patients with PD. Probands and relatives of patients with PD and panic disorder (PD-PANIC; N=20, N=115) and control probands with PD and no active psychiatric illness (PD-NA; N=17, N=108) were interviewed by phone, using a structured interview to determine panic status. Lifetime prevalence of panic and "panic-like" disorders was higher in PD-PANIC than in PD-NA relatives. Panic and "panic-like" disorders are familial disorders in PD.
Collapse
|