Clinical presentation and diagnosis of Parkinson’s disease in patients with schizophrenia spectrum disorders

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OBJECTIVE

To study the features of the clinical picture and diagnosis of Parkinson’s disease (PD) in patients with schizophrenia spectrum disorders (SSD).

MATERIAL AND METHODS

The analysis of databases of four psychoneurological dispensaries in Moscow with the allocation of groups of patients with diagnoses of SSD (F20—F25 according to ICD-10) was carried out. Among these groups, a targeted search for patients with an established diagnosis of PD (G20) was conducted. Among this category of patients, the incidence of PD, the therapy taken, the premotor symptoms of PD and the parameters characterizing the features of the clinical picture and diagnosis of PD were analyzed.

RESULTS

A total of 9124 patients with SSD were identified, among them 11 people diagnosed with PD, while the final incidence of PD was 0.1% (95% CI 0—0.2%). The average age at onset of SSD and PD was 33.18±8.72 years and 58.9±8.1 years, respectively. The average time between the appearance of the first signs of PD and the final diagnosis was 5.09±1.92 years. The most commonly used antipsychotic in the group of patients with PD was quetiapine (54.5%); clozapine and some typical antipsychotics were used less frequently. The most common premotor symptoms were apathy, depression, anxiety, constipation and orthostatic hypotension. Hyposmia and behavioral disorders in the REM sleep phase were less common.

CONCLUSION

The results confirm the difficulty of managing patients with comorbidity of PD and SSD. Psychiatrists should pay close attention to the features of motor symptoms in patients with SSD and carefully identify clinical signs that may indicate the presence of PD or other neurodegenerative diseases with parkinsonism.

Keywords:

Parkinson’s disease

schizophrenic spectrum disorders

neuroleptic parkinsonism

psychoneurological dispensary

Authors:

Khommyatov M.R.

Central State Medical Academy

ORCID: 0000-0003-3105-0812

Smolentseva I.G.

Russian Medical Academy of Continuous Professional Education

ORCID: 0000-0002-5569-6688

Golubev S.A.

Central State Medical Academy;
Gannushkin Psychiatric Clinical Hospital No. 4;
Mental Health Research Center

ORCID: 0000-0002-0021-4936

Goryunov A.V.

Mental Health Research Center

SPIN RSCI: 6932-3880
Scopus AuthorID: 35773220700
ResearcherID: B-9476-2017
ORCID: 0000-0002-2851-8843

Samushiya M.A.

Central State Medical Academy

ORCID: 0000-0003-3681-9977

Received:

27.06.2024

Accepted:

29.07.2024

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