Abstract
BackgroundHallucinations occur in 20–40% of PD patients and have been associated with unfavorable clinical outcomes (i.e., nursing home placement, increased mortality). Hallucinations, like other non-motor features of PD, are not well recognized in routine primary/secondary clinical practice. So far, there has been no instrument for uniform characterization of hallucinations in PD. To this end, we developed the University of Miami Parkinson's disease Hallucinations Questionnaire (UM-PDHQ) that allows comprehensive assessment of hallucinations in clinical or research settings.MethodsThe UM-PDHQ is composed of 6 quantitative and 14 qualitative items. For our study PD patients of all ages and in all stages of the disease were recruited over an 18-month period. The UPDRS, MMSE, and Beck Depression and Anxiety Inventories were used for comparisons.Results and DiscussionSeventy consecutive PD patients were included in the analyses. Thirty-one (44.3%) were classified as hallucinators and 39 as non-hallucinators. No significant group differences were observed in terms of demographics, disease characteristics, stage, education, depressive/anxiety scores or cognitive functioning (MMSE) between hallucinators and non-hallucinators. Single mode hallucinations were reported in 20/31 (visual/14, auditory/4, olfactory/2) whereas multiple modalities were reported in 11/31 patients. The most common hallucinatory experience was a whole person followed by small animals, insects and reptiles.ConclusionUsing the UM-PDHQ, we were able to define the key characteristics of hallucinations in PD in our cohort. Future directions include the validation of the quantitative part of the questionnaire than will serve as a rating scale for severity of hallucinations.
Highlights
Hallucinations occur in 20–40% of Parkinson's disease (PD) patients and have been associated with unfavorable clinical outcomes
Participant characteristics Seventy consecutive PD patients (46 men and 24 women) seen in our center were included in the analyses
Using the University of Miami Parkinson's disease Hallucinations Questionnaire (UM-PDHQ) 31 (44.3%) patients were classified as hallucinators and 39 were classified as non-hallucinators
Summary
Hallucinations occur in 20–40% of PD patients and have been associated with unfavorable clinical outcomes (i.e., nursing home placement, increased mortality). Hallucinations, like other non-motor features of PD, are not well recognized in routine primary/secondary clinical practice. Potentially treatable by anti-parkinsonian drug adjustments and the use of atypical antipsychotics [2], hallucinations have been associated with unfavorable clinical outcomes such as nursing home placement and increased mortality [3,4]. Hallucinations, like other non-motor features of PD, are not well recognized in routine clinical practice, either in primary or in secondary care, and are frequently missed during consultations [5].
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