More than 1 in 3 patients with Parkinson disease were found to experience minor hallucinations, which were linked with worse quality of life and poor sleep outcomes.
Minor hallucinations were found to be the most common psychotic symptom in patients with Parkinson disease (PD), in which those affected reported reduced health-related quality of life (QOL) and greater sleep symptom burden. Findings were published in Behavioural Neurology.
Although PD psychosis affects up to 75% of patients throughout the disease course, researchers highlight that prevalence of psychotic symptoms, including minor/major hallucinations and delusions, are typically understated and are not fully considered as key characteristics of the condition.
In fact, findings of a recent study showed that just 11% of caregivers reported having been educated by a physician on PD psychosis, with more respondents (21.4%) learning from personal research.
“Minor hallucinations deserve widespread attention because it is the most frequent and earliest type of psychotic phenomenon in PD and occurs even before the onset of motor symptoms,” said the researchers. “Minor hallucinations might also be an early predictor of a severe psychotic and cognitive state.”
Seeking to improve comprehension of the prevalence and clinical factors related to minor hallucinations in patients with PD, they derived demographic information from 262 patients with PD receiving care at the Brain Hospital of Nanjing Medical University between May 2019 and January 2021.
Participants answered a series of clinical assessment questionnaires, with results of the Movement Disorders Society Unified Parkinson’s Disease Rating Scale Part I leveraged to classify patients into eight strata:
Among the study cohort, 102 (38.9%) patients with PD experienced minor hallucinations, including 74 patients with isolated minor hallucinations (28.2%) and 28 patients with combined minor hallucinations (10.7%). Moreover, 14 patients and 1 patients reported incidence of isolated major hallucinations and delusions, respectively, and up to 32 (12.2%) patients had more than one kind of psychiatric symptoms. No hallucinations or delusions were reported by 141 patients.
Of the 74 patients with isolated minor hallucinations, the most common were visual illusion (48.4%), which included object misidentification (19.7%), pareidolias (13.9%), and kineptosia (14.8%).
Compared with patients with PD who reported no hallucinations, those with minor hallucinations were significantly associated with longer disease duration (P = .011), different daily levodopa equivalent dose (P = .038), and higher percentage of levodopa (P = .013) and dopamine-receptor agonist use (P = .042).
After accounting for confounding variables, patients with minor hallucinations were shown to have worse QOL and more severe nonmotor symptoms, including poor sleep quality (P < .001) and rapid eye movement sleep behavior disorder (RBD; P = .001), compared with those who did not have minor hallucinations.
Findings of an additional binary logistic regression model confirmed the associations between incidence of minor hallucinations and RBD, sleep quality, and health-related QOL.
In concluding, the study authors said that future studies on minor hallucinations need to confirm and expand the related clinical factors, which will offer strategies to improve the QOL of patients with PD.
Reference
Zhong M, Gu R, Zhu S, et al. Prevalence and risk factors for minor hallucinations in patients with Parkinson’s disease. Behav Neurol. Published online October 4, 2021. doi:10.1155/2021/3469706
Real-World Study Reveals Key Insights into DLBCL Treatment Patterns, Outcomes
April 18th 2024A recent study offers valuable insights into the characteristics, treatment patterns, and outcomes of diffuse large B-cell lymphoma (DLBCL) in patients across different lines of therapy, providing a look into the landscape of DLBCL management.
Read More
Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
Listen
Pegcetacoplan for PNH More Cost-Effective Than Anti-C5 Monoclonal Antibodies
April 18th 2024A cost-utility analysis conducted from the perspective of the Italian health system found that pegcetacoplan was more effective and less costly than 2 complement 5 (C5) inhibitors for the treatment of paroxysmal nocturnal hemoglobinuria (PNH).
Read More
Drs Raymond Thertulien, Joseph Mikhael on Racial Disparities in Multiple Myeloma Care Access
December 28th 2023In the wake of the 2023 American Society of Hematology Annual Meeting and Exposition, Raymond Thertulien, MD, PhD, of Novant Health, and Joseph Mikhael, MD, MEd, FRCPC, FACP, chief medical officer of the International Myeloma Foundation, discussed health equity research highlights from the meeting and drivers of racial disparities in multiple myeloma outcomes.
Listen
Gene and Cell Therapies Hold Potential—but How Can Payers Manage Their Costs?
April 18th 2024Presenters at the Academy of Managed Care Pharmacy (AMCP) 2024 annual meeting discussed the current promise and future potential of gene and cell therapies, as well as payer management strategies for these costly treatments.
Read More
Commonwealth Fund Report Details Pervasive Racial and Ethnic Disparities in US Health Care, Outcomes
April 18th 2024Using 25 health system performance indicators, the Commonwealth Fund 2024 State Health Disparities Report evaluated racial and ethnic disparities in health care and health outcomes both within and across US states and highlighted the urgent need for equitable health care policies and practices in the US.
Read More