Psychiatric aspects of Parkinson’s disease

Joanne A. Byars, Laura Marsh

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Typical consult question “Our patient is a fifty-eight year old man with Parkinson's disease. Lately, he seems uninterested and doesn't seem motivated to do anything anymore. Even when something good happens, he doesn't crack a smile. Is he depressed?” Background Overview of Parkinson's disease Parkinson's disease (PD) is a progressive neurodegenerative disease characterized by loss of dopaminergic neurons in the substantia nigra. Neurotransmission of serotonin, norepinephrine, and acetylcholine is also altered. The three principal motor symptoms of PD are rigidity, bradykinesia, and tremor. However, not all patients have all three motor symptoms. The classic tremor of PD is a rest tremor, but patients can have a postural or action tremor, or no tremor at all. Other early neurological signs include decreased facial expression (i.e., the masked face), or micrographia. Postural instability and autonomic dysfunction may occur later. About 1% of adults over age 60 have PD, with average age of onset in their sixties, although 5% to 10% of patients have young-onset PD, defined as onset before age 40. Although defined as a movement disorder, PD consists of overlapping motor, cognitive, and psychiatric features, which sometimes are difficult to distinguish. If a patient with PD has little emotional reactivity, is this the blunted affect of depression, an abulia characteristic of frontal-subcortical impairment, or the motor sign of facial masking? The frequency of psychiatric co-morbidities in PD and these phenomena of ambiguous origin often prompt psychiatric consultation.

Original languageEnglish (US)
Title of host publicationPsychosomatic Medicine: An Introduction to Consultation-Liaison Psychiatry
PublisherCambridge University Press
Pages116-125
Number of pages10
ISBN (Print)9780511776878, 9780521106658
DOIs
StatePublished - Jan 1 2010

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Parkinson Disease
Psychiatry
Tremor
Age of Onset
Hypokinesia
Facial Expression
Dopaminergic Neurons
Movement Disorders
Substantia Nigra
Synaptic Transmission
Neurodegenerative Diseases
Acetylcholine
Serotonin
Norepinephrine
Referral and Consultation
Depression
Morbidity

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Byars, J. A., & Marsh, L. (2010). Psychiatric aspects of Parkinson’s disease. In Psychosomatic Medicine: An Introduction to Consultation-Liaison Psychiatry (pp. 116-125). Cambridge University Press. https://doi.org/10.1017/CBO9780511776878.014

Psychiatric aspects of Parkinson’s disease. / Byars, Joanne A.; Marsh, Laura.

Psychosomatic Medicine: An Introduction to Consultation-Liaison Psychiatry. Cambridge University Press, 2010. p. 116-125.

Research output: Chapter in Book/Report/Conference proceedingChapter

Byars, JA & Marsh, L 2010, Psychiatric aspects of Parkinson’s disease. in Psychosomatic Medicine: An Introduction to Consultation-Liaison Psychiatry. Cambridge University Press, pp. 116-125. https://doi.org/10.1017/CBO9780511776878.014
Byars JA, Marsh L. Psychiatric aspects of Parkinson’s disease. In Psychosomatic Medicine: An Introduction to Consultation-Liaison Psychiatry. Cambridge University Press. 2010. p. 116-125 https://doi.org/10.1017/CBO9780511776878.014
Byars, Joanne A. ; Marsh, Laura. / Psychiatric aspects of Parkinson’s disease. Psychosomatic Medicine: An Introduction to Consultation-Liaison Psychiatry. Cambridge University Press, 2010. pp. 116-125
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