Relationship between hallucinations, delusions, and rapid eye movement sleep behavior disorder in Parkinson's disease
Identifieur interne : 000055 ( Istex/Corpus ); précédent : 000054; suivant : 000056Relationship between hallucinations, delusions, and rapid eye movement sleep behavior disorder in Parkinson's disease
Auteurs : Claudio Pacchetti ; Raffaele Manni ; Roberta Zangaglia ; Francesca Mancini ; Enrico Marchioni ; Cristina Tassorelli ; Michele Terzaghi ; Maria Ossola ; Emilia Martignoni ; Arrigo Moglia ; Giuseppe NappiSource :
- Movement Disorders [ 0885-3185 ] ; 2005-11.
English descriptors
Abstract
Psychotic symptoms are the main and the most disabling “nonmotor” complications of Parkinson's disease (PD), the pathophysiology of which is poorly recognized. Polysomnographic studies have shown a relationship between visual hallucinations and rapid eye movement (REM) sleep. The objective of this study is to clarify the relationship between psychotic symptoms and REM sleep behavior disorder (RBD) in PD. In a Parkinson's disease outpatient unit, 289 consecutive subjects with idiopathic PD were administered (in the period from January to December 2002) a multiple‐choice questionnaire and structured interview on sleep and mental disorders. RBD was diagnosed in accordance with the minimal diagnostic criteria of the International Classification of Sleep Disorders. Hallucinations and delusional disorders were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders‐IV criteria. The presence or absence of psychotic symptoms, of RBD, and of daytime sleepiness, as well as motor status, cognitive status, and mood were assessed. Approximately 32% (n = 92) of the subjects presented with psychotic disorders; 30% (n = 86) had experienced hallucinations; 2% (n = 6) had delusions without hallucinations. Sixty‐two (72%) hallucinators reported nocturnal hallucinations. A total of 6.6% (n = 19) of the subjects complained of a delusional disorder. There were 26.6% (n = 77) of subjects who presented with RBD: 28 (36%) with onset before and 49 (63%) with onset after PD diagnosis. The presence of RBD was associated with an increased risk of manifesting hallucinations and delusions (odds ratio [OR], 2.73). Other independent clinical factors found to have an effect on psychotic disorders were cognitive impairment (OR, 3.92), disease duration (OR, 2.46), advanced age (OR, 2.34), and severity of motor symptoms (OR, 2.06). These results suggest that RBD is widely associated with psychosis in PD. © 2005 Movement Disorder Society
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DOI: 10.1002/mds.20582
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ISTEX:C272B978803C82C5B330F524960FA20DCECC724BLe document en format XML
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Polysomnographic studies have shown a relationship between visual hallucinations and rapid eye movement (REM) sleep. The objective of this study is to clarify the relationship between psychotic symptoms and REM sleep behavior disorder (RBD) in PD. In a Parkinson's disease outpatient unit, 289 consecutive subjects with idiopathic PD were administered (in the period from January to December 2002) a multiple‐choice questionnaire and structured interview on sleep and mental disorders. RBD was diagnosed in accordance with the minimal diagnostic criteria of the International Classification of Sleep Disorders. Hallucinations and delusional disorders were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders‐IV criteria. The presence or absence of psychotic symptoms, of RBD, and of daytime sleepiness, as well as motor status, cognitive status, and mood were assessed. Approximately 32% (n = 92) of the subjects presented with psychotic disorders; 30% (n = 86) had experienced hallucinations; 2% (n = 6) had delusions without hallucinations. Sixty‐two (72%) hallucinators reported nocturnal hallucinations. A total of 6.6% (n = 19) of the subjects complained of a delusional disorder. There were 26.6% (n = 77) of subjects who presented with RBD: 28 (36%) with onset before and 49 (63%) with onset after PD diagnosis. The presence of RBD was associated with an increased risk of manifesting hallucinations and delusions (odds ratio [OR], 2.73). Other independent clinical factors found to have an effect on psychotic disorders were cognitive impairment (OR, 3.92), disease duration (OR, 2.46), advanced age (OR, 2.34), and severity of motor symptoms (OR, 2.06). These results suggest that RBD is widely associated with psychosis in PD. © 2005 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Claudio Pacchetti MD</name><affiliations><json:string>Parkinson's Disease and Movement Disorders Unit, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</json:string></affiliations></json:item><json:item><name>Raffaele Manni MD</name><affiliations><json:string>Sleep Medicine Unit, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</json:string></affiliations></json:item><json:item><name>Roberta Zangaglia MD</name><affiliations><json:string>Parkinson's Disease and Movement Disorders Unit, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</json:string></affiliations></json:item><json:item><name>Francesca Mancini MD, PhD</name><affiliations><json:string>Parkinson's Disease and Movement Disorders Unit, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</json:string></affiliations></json:item><json:item><name>Enrico Marchioni MD</name><affiliations><json:string>Laboratory of Epidemiology and Statistics, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</json:string></affiliations></json:item><json:item><name>Cristina Tassorelli MD, PhD</name><affiliations><json:string>Parkinson's Disease and Movement Disorders Unit, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</json:string></affiliations></json:item><json:item><name>Michele Terzaghi MD</name><affiliations><json:string>Sleep Medicine Unit, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</json:string></affiliations></json:item><json:item><name>Maria Ossola MD</name><affiliations><json:string>Parkinson's Disease and Movement Disorders Unit, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</json:string></affiliations></json:item><json:item><name>Emilia Martignoni MD</name><affiliations><json:string>Department of Medical Science, University “A. Avogadro”, Novara, Italy</json:string></affiliations></json:item><json:item><name>Arrigo Moglia MD</name><affiliations><json:string>Parkinson's Disease and Movement Disorders Unit, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</json:string></affiliations></json:item><json:item><name>Giuseppe Nappi MD</name><affiliations><json:string>Department of Neurology and Otolaryngology, University “La Sapienza”, Rome and IRCCS C. 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In a Parkinson's disease outpatient unit, 289 consecutive subjects with idiopathic PD were administered (in the period from January to December 2002) a multiple‐choice questionnaire and structured interview on sleep and mental disorders. RBD was diagnosed in accordance with the minimal diagnostic criteria of the International Classification of Sleep Disorders. Hallucinations and delusional disorders were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders‐IV criteria. The presence or absence of psychotic symptoms, of RBD, and of daytime sleepiness, as well as motor status, cognitive status, and mood were assessed. Approximately 32% (n = 92) of the subjects presented with psychotic disorders; 30% (n = 86) had experienced hallucinations; 2% (n = 6) had delusions without hallucinations. Sixty‐two (72%) hallucinators reported nocturnal hallucinations. A total of 6.6% (n = 19) of the subjects complained of a delusional disorder. There were 26.6% (n = 77) of subjects who presented with RBD: 28 (36%) with onset before and 49 (63%) with onset after PD diagnosis. The presence of RBD was associated with an increased risk of manifesting hallucinations and delusions (odds ratio [OR], 2.73). Other independent clinical factors found to have an effect on psychotic disorders were cognitive impairment (OR, 3.92), disease duration (OR, 2.46), advanced age (OR, 2.34), and severity of motor symptoms (OR, 2.06). 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Mondino Institute of Neurology, Pavia, Italy</affiliation></author><author><persName><forename type="first">Enrico</forename><surname>Marchioni</surname><roleName type="degree">MD</roleName></persName><affiliation>Laboratory of Epidemiology and Statistics, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</affiliation></author><author><persName><forename type="first">Cristina</forename><surname>Tassorelli</surname><roleName type="degree">MD, PhD</roleName></persName><affiliation>Parkinson's Disease and Movement Disorders Unit, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</affiliation></author><author><persName><forename type="first">Michele</forename><surname>Terzaghi</surname><roleName type="degree">MD</roleName></persName><affiliation>Sleep Medicine Unit, IRCCS C. 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Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2005-11"></date><biblScope unit="vol">20</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="1439">1439</biblScope><biblScope unit="page" to="1448">1448</biblScope></imprint></monogr><idno type="istex">C272B978803C82C5B330F524960FA20DCECC724B</idno><idno type="DOI">10.1002/mds.20582</idno><idno type="ArticleID">MDS20582</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2005</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Psychotic symptoms are the main and the most disabling “nonmotor” complications of Parkinson's disease (PD), the pathophysiology of which is poorly recognized. Polysomnographic studies have shown a relationship between visual hallucinations and rapid eye movement (REM) sleep. The objective of this study is to clarify the relationship between psychotic symptoms and REM sleep behavior disorder (RBD) in PD. In a Parkinson's disease outpatient unit, 289 consecutive subjects with idiopathic PD were administered (in the period from January to December 2002) a multiple‐choice questionnaire and structured interview on sleep and mental disorders. RBD was diagnosed in accordance with the minimal diagnostic criteria of the International Classification of Sleep Disorders. Hallucinations and delusional disorders were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders‐IV criteria. The presence or absence of psychotic symptoms, of RBD, and of daytime sleepiness, as well as motor status, cognitive status, and mood were assessed. Approximately 32% (n = 92) of the subjects presented with psychotic disorders; 30% (n = 86) had experienced hallucinations; 2% (n = 6) had delusions without hallucinations. Sixty‐two (72%) hallucinators reported nocturnal hallucinations. A total of 6.6% (n = 19) of the subjects complained of a delusional disorder. There were 26.6% (n = 77) of subjects who presented with RBD: 28 (36%) with onset before and 49 (63%) with onset after PD diagnosis. The presence of RBD was associated with an increased risk of manifesting hallucinations and delusions (odds ratio [OR], 2.73). Other independent clinical factors found to have an effect on psychotic disorders were cognitive impairment (OR, 3.92), disease duration (OR, 2.46), advanced age (OR, 2.34), and severity of motor symptoms (OR, 2.06). These results suggest that RBD is widely associated with psychosis in PD. © 2005 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Parkinson's disease</term></item><item><term>REM sleep behavior disorder</term></item><item><term>hallucinations</term></item><item><term>delusions</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>Article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2004-09-17">Received</change><change when="2005-02-03">Registration</change><change when="2005-11">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/C272B978803C82C5B330F524960FA20DCECC724B/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="subtitle">Official Journal of the Movement Disorder Society</title><title type="short">Mov. Disord.</title></titleGroup></publicationMeta><publicationMeta level="part" position="110"><doi origin="wiley" registered="yes">10.1002/mds.v20:11</doi><numberingGroup><numbering type="journalVolume" number="20">20</numbering><numbering type="journalIssue">11</numbering></numberingGroup><coverDate startDate="2005-11">November 2005</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="70" status="forIssue"><doi origin="wiley" registered="yes">10.1002/mds.20582</doi><idGroup><id type="unit" value="MDS20582"></id></idGroup><countGroup><count type="pageTotal" number="10"></count></countGroup><titleGroup><title type="articleCategory">Research Article</title><title type="tocHeading1">Research Articles</title></titleGroup><copyright ownership="thirdParty">Copyright © 2005 Movement Disorder Society</copyright><eventGroup><event type="manuscriptReceived" date="2004-09-17"></event><event type="manuscriptRevised" date="2005-02-01"></event><event type="manuscriptAccepted" date="2005-02-03"></event><event type="publishedOnlineEarlyUnpaginated" date="2005-07-18"></event><event type="firstOnline" date="2005-07-18"></event><event type="publishedOnlineFinalForm" date="2005-10-27"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.3.2 mode:FullText source:FullText result:FullText" date="2010-03-09"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-31"></event></eventGroup><numberingGroup><numbering type="pageFirst">1439</numbering><numbering type="pageLast">1448</numbering></numberingGroup><correspondenceTo>Movement Disorders Center, IRCCS “C. Mondino”, Via Mondino 2, 27100 Pavia, Italy</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS20582.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="0"></count><count type="tableTotal" number="6"></count><count type="referenceTotal" number="62"></count><count type="wordTotal" number="7100"></count></countGroup><titleGroup><title type="main" xml:lang="en">Relationship between hallucinations, delusions, and rapid eye movement sleep behavior disorder in Parkinson's disease</title><title type="short" xml:lang="en">Psychotic Symptoms and RBD in PD</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Claudio</givenNames><familyName>Pacchetti</familyName><degrees>MD</degrees></personName><contactDetails><email>claudio.pacchetti@mondino.it</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Raffaele</givenNames><familyName>Manni</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Roberta</givenNames><familyName>Zangaglia</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Francesca</givenNames><familyName>Mancini</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Enrico</givenNames><familyName>Marchioni</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Cristina</givenNames><familyName>Tassorelli</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Michele</givenNames><familyName>Terzaghi</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Maria</givenNames><familyName>Ossola</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au9" creatorRole="author" affiliationRef="#af4"><personName><givenNames>Emilia</givenNames><familyName>Martignoni</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au10" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Arrigo</givenNames><familyName>Moglia</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au11" creatorRole="author" affiliationRef="#af5"><personName><givenNames>Giuseppe</givenNames><familyName>Nappi</familyName><degrees>MD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="IT" type="organization"><unparsedAffiliation>Parkinson's Disease and Movement Disorders Unit, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="IT" type="organization"><unparsedAffiliation>Sleep Medicine Unit, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="IT" type="organization"><unparsedAffiliation>Laboratory of Epidemiology and Statistics, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="IT" type="organization"><unparsedAffiliation>Department of Medical Science, University “A. Avogadro”, Novara, Italy</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="IT" type="organization"><unparsedAffiliation>Department of Neurology and Otolaryngology, University “La Sapienza”, Rome and IRCCS C. Mondino Institute of Neurology, Pavia, Italy</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Parkinson's disease</keyword><keyword xml:id="kwd2">REM sleep behavior disorder</keyword><keyword xml:id="kwd3">hallucinations</keyword><keyword xml:id="kwd4">delusions</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Psychotic symptoms are the main and the most disabling “nonmotor” complications of Parkinson's disease (PD), the pathophysiology of which is poorly recognized. Polysomnographic studies have shown a relationship between visual hallucinations and rapid eye movement (REM) sleep. The objective of this study is to clarify the relationship between psychotic symptoms and REM sleep behavior disorder (RBD) in PD. In a Parkinson's disease outpatient unit, 289 consecutive subjects with idiopathic PD were administered (in the period from January to December 2002) a multiple‐choice questionnaire and structured interview on sleep and mental disorders. RBD was diagnosed in accordance with the minimal diagnostic criteria of the International Classification of Sleep Disorders. Hallucinations and delusional disorders were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders‐IV criteria. The presence or absence of psychotic symptoms, of RBD, and of daytime sleepiness, as well as motor status, cognitive status, and mood were assessed. Approximately 32% (n = 92) of the subjects presented with psychotic disorders; 30% (n = 86) had experienced hallucinations; 2% (n = 6) had delusions without hallucinations. Sixty‐two (72%) hallucinators reported nocturnal hallucinations. A total of 6.6% (n = 19) of the subjects complained of a delusional disorder. There were 26.6% (n = 77) of subjects who presented with RBD: 28 (36%) with onset before and 49 (63%) with onset after PD diagnosis. The presence of RBD was associated with an increased risk of manifesting hallucinations and delusions (odds ratio [OR], 2.73). Other independent clinical factors found to have an effect on psychotic disorders were cognitive impairment (OR, 3.92), disease duration (OR, 2.46), advanced age (OR, 2.34), and severity of motor symptoms (OR, 2.06). These results suggest that RBD is widely associated with psychosis in PD. © 2005 Movement Disorder Society</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><!--Version 0.6 générée le 3-12-2015--><mods version="3.6"><titleInfo lang="en"><title>Relationship between hallucinations, delusions, and rapid eye movement sleep behavior disorder in Parkinson's disease</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Psychotic Symptoms and RBD in PD</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Relationship between hallucinations, delusions, and rapid eye movement sleep behavior disorder in Parkinson's disease</title></titleInfo><name type="personal"><namePart type="given">Claudio</namePart><namePart type="family">Pacchetti</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Parkinson's Disease and Movement Disorders Unit, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</affiliation><description>Correspondence: Movement Disorders Center, IRCCS “C. Mondino”, Via Mondino 2, 27100 Pavia, Italy</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Raffaele</namePart><namePart type="family">Manni</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Sleep Medicine Unit, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Roberta</namePart><namePart type="family">Zangaglia</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Parkinson's Disease and Movement Disorders Unit, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Francesca</namePart><namePart type="family">Mancini</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Parkinson's Disease and Movement Disorders Unit, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Enrico</namePart><namePart type="family">Marchioni</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Laboratory of Epidemiology and Statistics, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Cristina</namePart><namePart type="family">Tassorelli</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Parkinson's Disease and Movement Disorders Unit, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Michele</namePart><namePart type="family">Terzaghi</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Sleep Medicine Unit, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Maria</namePart><namePart type="family">Ossola</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Parkinson's Disease and Movement Disorders Unit, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Emilia</namePart><namePart type="family">Martignoni</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Medical Science, University “A. Avogadro”, Novara, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Arrigo</namePart><namePart type="family">Moglia</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Parkinson's Disease and Movement Disorders Unit, IRCCS C. Mondino Institute of Neurology, Pavia, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Giuseppe</namePart><namePart type="family">Nappi</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology and Otolaryngology, University “La Sapienza”, Rome and IRCCS C. Mondino Institute of Neurology, Pavia, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre authority="originalCategForm">article</genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2005-11</dateIssued><dateCaptured encoding="w3cdtf">2004-09-17</dateCaptured><dateValid encoding="w3cdtf">2005-02-03</dateValid><copyrightDate encoding="w3cdtf">2005</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="tables">6</extent><extent unit="references">62</extent><extent unit="words">7100</extent></physicalDescription><abstract lang="en">Psychotic symptoms are the main and the most disabling “nonmotor” complications of Parkinson's disease (PD), the pathophysiology of which is poorly recognized. Polysomnographic studies have shown a relationship between visual hallucinations and rapid eye movement (REM) sleep. The objective of this study is to clarify the relationship between psychotic symptoms and REM sleep behavior disorder (RBD) in PD. In a Parkinson's disease outpatient unit, 289 consecutive subjects with idiopathic PD were administered (in the period from January to December 2002) a multiple‐choice questionnaire and structured interview on sleep and mental disorders. RBD was diagnosed in accordance with the minimal diagnostic criteria of the International Classification of Sleep Disorders. Hallucinations and delusional disorders were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders‐IV criteria. The presence or absence of psychotic symptoms, of RBD, and of daytime sleepiness, as well as motor status, cognitive status, and mood were assessed. Approximately 32% (n = 92) of the subjects presented with psychotic disorders; 30% (n = 86) had experienced hallucinations; 2% (n = 6) had delusions without hallucinations. Sixty‐two (72%) hallucinators reported nocturnal hallucinations. A total of 6.6% (n = 19) of the subjects complained of a delusional disorder. There were 26.6% (n = 77) of subjects who presented with RBD: 28 (36%) with onset before and 49 (63%) with onset after PD diagnosis. The presence of RBD was associated with an increased risk of manifesting hallucinations and delusions (odds ratio [OR], 2.73). Other independent clinical factors found to have an effect on psychotic disorders were cognitive impairment (OR, 3.92), disease duration (OR, 2.46), advanced age (OR, 2.34), and severity of motor symptoms (OR, 2.06). These results suggest that RBD is widely associated with psychosis in PD. © 2005 Movement Disorder Society</abstract><subject lang="en"><genre>Keywords</genre><topic>Parkinson's disease</topic><topic>REM sleep behavior disorder</topic><topic>hallucinations</topic><topic>delusions</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title><subTitle>Official Journal of the Movement Disorder Society</subTitle></titleInfo><titleInfo type="abbreviated"><title>Mov. 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